Patient was met in the preoperative holding area, consent was confirmed and all questions were answered. Patient was transported back to the operating room placed on the OR table in the supine position, bony areas padded, left arm tucked, sequential compression devices applied to the bilateral legs and secured with straps. General anesthesia was induced, and patient was intubated without issue. [Abx] was given prior to the procedure. The abdomen was prepped and draped in normal sterile fashion and a timeout was done and were all in agreement.
The abdomen was accessed via supraumbilical cutdown and placement of 12mm trocar. The abdomen was insufflated to [8/15] mmHg there was no visceral injury upon entry. A 5 mm port was placed in the left lower quadrant area as well as a 5 mm left mid abdomen port under direct vision without visceral injury. The patient was positioned in Trendelenburg position with right side up. The abdomen was surveyed, the small bowel pushed aside, and the cecum and the right colon were gently moved medially revealing the appendix. It was noted to be [appearance].
[Accessory ports]
[PICK ONE] The mesoappendix was divided with the harmonic scalpel to the base of the appendix. The appendix was divided with Endo GIA linear 45 mm blue load stapler.
[PICK ONE] A window was made at the base of the cecum, and it was transected with the Endo GIA linear 45 mm blue load stapler. The mesoappendix was divided with the harmonic scalpel.
The staple line was intact and hemostatic.
The appendix was placed in the bag and removed through the umbilical incision. The right lower quadrant was inspected there is again staple line looked good and there was no abscess or fluid collections.
The umbilical fascia was closed with a size 0 Vicryl suture in a figure-of-eight fashion. The skin was closed throughout with 4-0 Monocryl and dressed with Dermabond. Final counts were correct. The patient was liberated from anesthesia and transported PACU in stable condition.
Dr. [] was present for the entire case.
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Author: Garrett Skinner