AppendectomyAppendectomy24/10/2324/10/23221.1.IntroductionIntroductionFitz1880AppendicitisFitz1880AppendicitisMcBuney1894McBuney1894AppendectomyAppendectomy2.2.AnatomyofAppendixAnatomyofAppendix24/10/2324/10/233324/10/2324/10/234424/10/2324/10/2355(mesoappendix)24/10/2324/10/236624/10/2324/10/2377IndicationIndicationAppendicitisAppendicitis24/10/2324/10/238824/10/2324/10/2399PreoperativepreparationPreoperativepreparationGeneralpreparationGeneralpreparation24/10/2324/10/231010AnesthesiaAnesthesia1.1.Local(Regional)AnesthesiaLocal(Regional)Anesthesia2.2.EpiduralAnesthesiaEpiduralAnesthesia3.GeneralAnesthesia3.GeneralAnesthesia24/10/2324/10/231111WiththepatientinthesupineWiththepatientinthesupineposition,generalanesthesiaisposition,generalanesthesiaisinducedandtheabdomenisinducedandtheabdomenispreparedanddrapedinasterilepreparedanddrapedinasterilefashionsoastoexposetherightfashionsoastoexposetherightlowerquadrant.lowerquadrant.24/10/2324/10/23121224/10/2324/10/23131324/10/2324/10/231414TheclassicMcBurneyincisionismadeatTheclassicMcBurneyincisionismadeatapointtwo-thirdsthedistanceapointtwo-thirdsthedistance(McBurney'spoint)betweenumbilicusand(McBurney'spoint)betweenumbilicusandanteriorsuperiorspineoftheilium.Theanteriorsuperiorspineoftheilium.Theincisionisperpendiculartotheconnectingincisionisperpendiculartotheconnectingline,andismadeonethirdaboveandtwoline,andismadeonethirdaboveandtwothirdsbelowtheline.thirdsbelowtheline.24/10/2324/10/231515What’stheproperlengthofWhat’stheproperlengthofincisionincision??Assmallaspossible,butasAssmallaspossible,butaslargeasnessisary!largeasnessisary!24/10/2324/10/23161624/10/2324/10/23171724/10/2324/10/23181824/10/2324/10/23191924/10/2324/10/23202024/10/2324/10/23212124/10/2324/10/23222224/10/2324/10/23232324/10/2324/10/23242424/10/2324/10/23252524/10/2324/10/23262624/10/2324/10/23272724/10/2324/10/23282824/10/2324/10/23292924/10/2324/10/23303024/10/2324/10/23313124/10/2324/10/23323224/10/2324/10/23333324/10/2324/10/233434interruptedsutures24/10/2324/10/23353524/10/2324/10/233636fecolith24/10/2324/10/23373724/10/2324/10/23383824/10/2324/10/233939LaparoscopicappendectomyLaparoscopicappendectomy24/10/2324/10/23404024/10/2324/10/23414124/10/2324/10/23424224/10/2324/10/23434324/10/2324/10/23444424/10/2324/10/23454524/10/2324/10/23464624/10/2324/10/23474724/10/2324/10/23484824/10/2324/10/23494924/10/2324/10/235050