Appendicectomy

topic: appendicectomy
-ranjana chaurasia

1. APPENDICECTOMY

2. INTRODUCTION: An appendicectomy is a surgical operation in which the vermiform appendix is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat acute appendicitis. Appendicectomy may be performed laproscopiocally ( key hole surgery) or as an open operation.

3. Indications: Acute appendicitis – acute appendicectomy Recurrent appendicitis –elective appendicectomy

4. Contraindication: Appendicular mass

5. Position of the patient: supine Anesthesia of the parts: the surgery can be performed either under general Anesthesia or regional anesthesia. Preparation of the patient: parts are cleaned with iodine and spirit from the Level of umbilicus above to the upper part of the thigh below. INCISION: McBurney’s grid – iron incision

6. Lanz incision: Right paramedian incision:

7. Features of acute appendicitis at operation: Inflamed, turgid appendix Pus in the right iliac fossa Presence of omentum in the right iliac fossa Black or green appendix faecolith #Surgical procedure

8. Post operative management: 1) Ryle’s tube aspiration for one two days 2) IV fluids 2.5 liters/day for one or two days 3) Oral fluids are allowed once abdomen is soft and bowel sounds are heard. 4) Appropriate antibiotics to cover gram positive, gram negative and anaerobic Organisms 5) Suture removal in 7 -10 days

9. COMPLICATIONS: Postoperative fever Wound infection Intra- abdominal abscess Fecal fistula septicemia