Isn't the internet grand?
From this website.
- Make a skin incision. Incise the adipose tissue and retract with Army/Navy retractors.
Clamp, cut and tie the vessels in the adipose tissue.
- Dissect through the adipose layer, and grasp the fascia with two kellys and incise with the deep knife.
Gelpi self-retaining retractors can also be used.
- Dissect through the muscle. Pick up the posterior fascia with two kellys, incise with the deep knife and extend the incision.
- Grasp the peritoneum with two kellys, incise with the deep knife and extend the incision.
- Grasp the appendix with a Babcock clamp. (Cultures could be taken at this time.) Crush the base of the appendix with a clamp and place an O-Chromic tie at the base.
- Excise the appendix. Pass the specimen with the dirty instruments to the technologist. Place a purse string suture around the stump of the appendix. Tighten the purse string stitch, tie and cut.
- Close the peritoneum with suture of choice. (Drains may be placed at this time.)
- We recommend that the fascia be closed using an inturrupted stitch with an eyed needle. This gives the student the opportunity to practice threading and passing eyed suture.
- Close the adipose and skin layers in the usual fashion. Skin staples or steri-strips may be used if desired.
My response? OUCH!
(Also? Do NOT Google for Appendectomy pictures. URGH.)