Laparoscopic Appendectomy
Preop Diagnosis - appendicitis
Postop Diagnosis - same
Surgeon - Dr. Luk / Dr. Tran
Assistant Surgeon -
Anesthesia - General
Blood Loss - Minimal
Complication - None
Findings - appendicitis
Specimens - appendix
Procedure performed: laparoscopic appendectomy
Patient comes in with the above diagnosis and was consented for the above procedures. Risks, benefits, and alternatives were discussed with patient, which includes, but are not limited to, postoperative or chronic pain, bleeding, wound infection, hematoma, post-operative abscess, injury to other organs, or need for further procedures or workup. Other Complications may include deep vein thrombosis(blood clots), as well as other side effects affecting other organ systems such as the heart or lungs, and in rare circumstances, death as a result of the above complications. The patient understands and agrees to proceed with the proposed procedure.
After consent was obtained, the patient was brought to the OR and underwent general anesthesia. The patient was prep and draped in the standard manner.
Timeout was performed and all was in agreement.
The patient was given preoperative antibiotics.
A small incision was made at the umbilicus using the scalpel. Dissection was carried down to the fascia using the retractors. Once the fascia was opened, a trocar was placed into the abdomen. Next, CO2 gas was used to insufflate the abdomen. Examination of entrance site did not reveal any injury to the intra-abdominal structures during the entrance process. The pt was placed into position.
Next, two additional incisions and trocars were placed in the standard locations for laparoscopic appendectomy. These were placed under direct visualization.
The appendix was identified. Inflammatory changes is noted with no evidence of perforation or abscess. It was skeletonized using a laparoscopic dissector. When this was completed, the appendix was divided and sealed at the base using an endo-gia stapler.
Care was taken to control any bleeding at the dissecting bed. Area was then washed with copious amount of saline irrigation
Hemostasis was completely obtained. There were no injuries to the other organs seen. Staple line is intact with no leakage of enteric content.
Once the appendix was removed, it was placed in a laparoscopic retrieval bag.
Finally, the appendix was removed from the abdominal cavity through the umbilical trocar site in its entirety without complications. C02 was released from the abdominal cavity and the trocars were then removed, no bleeding at the sites.
At the end of the case, counts were carried out. When instrument, sponge, and needle
counts were completed and reported to me as correct, then I began the closure.
The fascia was closed using either #1 prolene suture.
The skin incisions were closed using absorbable sutures after injection of local anesthetic.
The pt tolerated the procedure well, no complications, extubated, and was transferred to the recovery room in stable and satisfactory conditions.
Laparoscopic Appendectomy with drain
Preop Diagnosis - appendicitis
Postop Diagnosis - same
Surgeon - Dr. Luk / Dr. Tran
Assistant Surgeon -
Anesthesia - General
Blood Loss - Minimal
Complication - None
Findings - appendicitis with abscess/perforation
Specimens - appendix
Procedure performed: laparoscopic appendectomy
intra-abdominal tunnel drain placement
Patient comes in with the above diagnosis and was consented for the above procedures. Risks, benefits, and alternatives were discussed with patient, which includes, but are not limited to, postoperative or chronic pain, bleeding, wound infection, hematoma, post-operative abscess, injury to other organs, or need for further procedures or workup. Other Complications may include deep vein thrombosis(blood clots), as well as other side effects affecting other organ systems such as the heart or lungs, and in rare circumstances, death as a result of the above complications. The patient understands and agrees to proceed with the proposed procedure.
After consent was obtained, the patient was brought to the OR and underwent general anesthesia. The patient was prep and draped in the standard manner.
Timeout was performed and all was in agreement.
The patient was given preoperative antibiotics.
A small incision was made at the umbilicus using the scalpel. Dissection was carried down to the fascia using the retractors. Once the fascia was opened, a trocar was placed into the abdomen. Next, CO2 gas was used to insufflate the abdomen. Examination of entrance site did not reveal any injury to the intra-abdominal structures during the entrance process. The pt was placed into position.
Next, two additional incisions and trocars were placed in the standard locations for laparoscopic appendectomy. These were placed under direct visualization.
The appendix was identified. Inflammatory changes is noted with evidence of perforation/abscess. There is significant inflammatory changes noted localized at the right lower quadrant. It was skeletonized using a laparoscopic dissector. When this was completed, the appendix was divided and sealed at the base using an endo-gia stapler. Once the appendix was removed, it was placed in a laparoscopic retrieval bag.
Care was taken to control any bleeding at the dissecting bed. Area was then washed with copious amount of saline irrigation
Hemostasis was completely obtained. There were no injuries to the other organs seen. Staple line is intact with no leakage of enteric content.
A 19 French Blake drain is placed, tunnel intra-abdominally overlying the site of right lower quadrant/pelvic region to avoid future abscess. This is secured with 2 nylon suture.
Finally, the appendix was removed from the abdominal cavity through the umbilical trocar site in its entirety without complications. C02 was released from the abdominal cavity and the trocars were then removed, no bleeding at the sites.
At the end of the case, counts were carried out. When instrument, sponge, and needle
counts were completed and reported to me as correct, then I began the closure.
The fascia was closed using either #1 prolene suture.
The skin incisions were closed using absorbable sutures after injection of local anesthetic.
The pt tolerated the procedure well, no complications, extubated, and was transferred to the recovery room in stable and satisfactory conditions.