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