This document outlines the procedure for laparoscopic appendectomy. It describes indications for the surgery as acute appendicitis, subacute appendicitis, or for diagnostic purposes. General anesthesia is used and the patient is positioned supine with a slight left tilt. Risks of the surgery including post-op adhesions, intra-abdominal abscess, and injury to hollow viscus or blood vessels are explained. The document then details the positioning of the patient and surgeon, placement of ports, identification and skeletonization of the appendix, ligation of the appendix base, and transaction or removal of the appendix. Alternate methods including a stapler technique are also mentioned.

1. LAPAROSCOPIC
APPNDICECTOMY
DR.B.Selvaraj MS; Mch; FICS;
Professor of Surgery
Melaka Manipal Medical College
Melaka 75150 Malaysia
OPERATIVE SURGERY

2. LAPAROSCOPIC APPENDICECTOMY
• INDICATIONS:
- Ac. Appendicitis
- Subacute Appendicitis
- Diagnostic Laparoscopy in
doubtful cases
• ANESTHESIA:
- GA (ET)
• POSITION:
- Supine with slight left tilt
• Informed consent- risks of surgery:
- Post-op adhesions < 1%
- Intra abdominal abscess <8%
- Fecal fistula < 2%
- Injury to hollow viscus & vascular
injury
- Hypercarbia
- Air embolism
- Conversion to open method if dense
adhesions

3. LAPAROSCOPIC APPENDICECTOMY
• Position of patient &
surgeon
• Port Placement

4. LAPAROSCOPIC APPENDICECTOMY
• Identification of Appendix • Skeletonisation of Appendix

5. LAPAROSCOPIC APPENDICECTOMY
• Ligation of appendix base • Transaction of Appendix

6. LAPAROSCOPIC APPENDICECTOMY
• Alternate Method • Stapler Method

7. LAPAROSCOPIC APPENDICECTOMY
• Retrocecal Appendicitis • Retrograde Appendicectomy

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