Researching the Procedure

So an appendectomy sounds fairly routine, or so I thought. I then also though I had a fairly strong constitution, I mean I've seen a few gory movies and enough murder and mayhem from the news to have considered myself to be resilient - click - play on the first in the selection of videos on YouTube on the procedure and well.. not so much.

An open appendectomy is the procedure in which a surgeon removes a problematic appendix, that in a healthy state should be a worm shaped organelle at the base of your large intestine, but now infected and ripe for removal, a now plump sausage shaped mass which has ruined your appetite, probably given you a fever and acute abdominal pain.

An appendix that is to be removed is generally part the point of no return and hence the reason why you're under the knife of a seasoned surgeon. The question is how does a surgeon get to this point, the point of confidence to operate, at least in the beginning.

Let me give you a brief overview of what is entailed - the uncomplicated in an out procedure:

- an incision is made in the abdomen through the skin subcutaneous fat layer to expose the exterior oblique muscle.
- the exterior oblique muscle is parted, not always cut, but the muscle fibers are parted to allow access to the interior oblique muscle layer.
- the interior oblique, as with the exterior oblique is parted rather than cut, whereby access to the underlying transverse oblique muscle.
- again as before the transverse abdominus muscle is parted rather then cut allowing access and exposing the peritoneum.
-the peritoneum is the call it a bag like structure that keeps the gory movie bits inside the abdominal cavity.
- the peritoneum is handled gingerly as the bowel can be in close proximity, so it is carefully lifted and help in position with a set of clamps and the the surgeon confirms, through a physical examination, that there is nothing immediately below the surface.
- the peritoneum is then opened with a small incision by scissors.
- a visual inspection is performed of the opening to get an idea of how bad things are below.
- if it's ok the opening is enlarged, again by scissors, and if necessary a swab of any visible fluid is taken and sent to histapathology.
- the surgeon the locates the offending appendix, carefully removes it, seals off any blood vessels, sutures it all up, cleans up and suctions any mess, and then starts the reverse process of closing things up.

But now this procedure is in decline in favor of a laparoscopic procedure, however from time to time the need arises to get in there the old fashioned way. It is this old fashioned way that we are required to replicate for aspiring surgeons to practice on.

In further posts we'll present the development and learning through a detailed and exhaustive analysis of the procedure. We will investigate the procedure independently, documenting our observations of the procedure as it may be performed routinely, possible variations or complications. We also hope to be able to witness the procedure first hand which will further our understanding of more that just the procedure.


Benchmark Procedures:

  1. Procedure: Open Appendectomy
    Website: YouTube
    Weblink: https://youtu.be/0YIq9d1mmQU
  2. Procedure: Open Appendectomy
    Website: LinkedIn Slideshare
    Web Link: https://www.slideshare.net/reddybams/appendicectomy-16289905

Deviant Procedures:


  1. Procedure: Open Appendectomy
    Website: YouTube
    Weblink: https://youtu.be/0YIq9d1mmQU

Abnormalities
:
  1. Condition: Pinworm parasite
    Website: PubMed.com
    Web Link: https://www.ncbi.nlm.nih.gov/pubmed/27364910
  2. Condition: Spontaneous splenic rupture four days after an open appendicectomy
    Website: PubMed.com
    Web Link: https://www.ncbi.nlm.nih.gov/pubmed/25723677
  3. Condition: Appendicitis in double cecal appendix: Case report
    Website: PubMed.com
    Web Link: https://www.ncbi.nlm.nih.gov/pubmed/25133154
  4. Condition: Veriformis Duplex
    Website: PubMed.com
    Web Link: https://www.ncbi.nlm.nih.gov/pubmed/16091877
  5. Condition: Crohn’s disease of the appendix
    Website: PubMed.com
    Web Link: https://www.ncbi.nlm.nih.gov/pubmed/11569518

Misc. References:

Medical Tools: http://www.medical-tools.com/shop/home.php

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