Details of Procedure
The patient was correctly identified, transferred to the operative room. General anesthesia was administered. After his abdomen was prepped and draped in a sterile fashion, a mid-line supraumbilical incision was made and an open Hassan procedure used to place a 12mm trochar. The abdomen was insuflated to 15mmHg. I then placed a 5mm suprapubic port followed by a 5mm left lower quadrant port.
The appendix was visualized in the right lower quadrant. The appendix was grasped and the base of the appendix appeared healthy. I then transected the mesoappendix from the appendix using the harmonic. This dissection extended to include the appendiceal artery. The appendix was then ligated with a PDS endoloop at the base and a second endoloop more distal. I then used the harmonic to transect the appendix between the endoloops. Hemostasis was obtained. The appendix was placed in an endocatch bag.
The abdomen was irrigated with copious saline. The appendix was removed through the umbilicus in the endocatch bag. The abdomen was desuflated and umbilical fascia closed with 0-vicryl. All skin incisions were irrigated and closed with 4-0 monocryl. Local anesthesia and Dermabond were applied.