Monday, June 18, 2007

Instructions for a DIY Appendectomy

For the DIY kind of person, here's the surgical steps for an appendectomy.
Isn't the internet grand?
From this website.
  1. Make a skin incision. Incise the adipose tissue and retract with Army/Navy retractors.
    Clamp, cut and tie the vessels in the adipose tissue.
  2. 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.
  3. Dissect through the muscle. Pick up the posterior fascia with two kellys, incise with the deep knife and extend the incision.
  4. Grasp the peritoneum with two kellys, incise with the deep knife and extend the incision.
  5. 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.
  6. 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.
  7. Close the peritoneum with suture of choice. (Drains may be placed at this time.)
  8. 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.
  9. 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.)

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