Appendoectomy

The Appendoectomy procedure

1. Overtube is pre-loaded on the colonoscope Procedural Sequence

Navigation Mode Procedural Sequence
Colonoscope is maneuvered to the caecum with the Overtube in the retracted position

Procedural Sequence
Caecum is imaged once it is reached by the colonoscope

Procedural Sequence
Manipulator Device is introduced via the working channel over the guidewire

System in the caecum with catheter in the appendix

Guidewire Depth Markers Manipulator Device Procedural Sequence
Manipulator Device is inserted into the appendix using the guidewire to cross the ostium (Balloon dilation is often required)

Procedural Sequence
Appendix is irrigated to remove fecal & other foreign matter

Procedural Sequence
Guidewire is replaced with stylet to perform manipulation to assess mobility of the appendix

Procedural Sequence
Overtube & Inverter Catheter are advanced over the scope
Guidewire is placed through the ostium

Procedural Sequence
Inverter Catheter is inserted
Overtube is advanced against caecal wall to provide counterforce
Sealing Sleeve is advanced over the unused vacuum holes

Procedural Sequence
Vacuum is applied
Appendix inverts “From the base” as the catheter is retracted
Cautery is utilized to dissect the wall to aid tissue inversion

Procedural Sequence
Inversion is completed
Ligature is cinched

Snare Procedural Sequence
Polypectomy snare is advanced via the working channel to perform resection

Scissors Snare captures appendix Procedural Sequence
Suture tail is trimmed & the polypectomy snare is used for appendix retrieval

Procedural Sequence
Appendix is removed leaving the Overtube in place

Procedural Sequence
Colonoscope is reinserted
Overtube and scope are removed under direct visualization

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Appendoectomy

by medgadget on Jan 14, 2008

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Appendoectomy — Presentation Transcript