Appendectomy iOS application Laparoscopic Appendectomy

laparoscopictrainingsimulation

Background Laparoscopic appendectomy is the surgical removal of the appendix via a minimally invasive technique. The use of laparoscopic surgery in the management of acute appendicitis (AA) was first described in 1983, with a continued increasing trend in its use. The literature describes decreased pain, earlier resumption of diet, and a decreased length of hospital stay. Key anatomy The appendix arises from the posteromedial aspect of the caecum about 2.5cm below the ileocaecal valve. Its length can vary from 12mm to 22cm. The position of the appendix is extremely variable. The common positions are as follows: • Retrocaecal (75%). The appendix is usually free in this position but can lie behind the peritoneal covering of the caecum, making dissection more challenging. If the appendix is very long, it can even extend behind the ascending colon. • Pelvic (20%). The appendix lies either just below the caecum or hanging down into the pelvis. • Pre-ileal or retro-ileal (5%). Contra-indications The absolute contraindications to a laparoscopic approach include hemodynamic instability and lack of surgical experience. Relative contraindications include generalized peritonitis, multiple previous surgical procedures, severe pulmonary disease, pregnancy, and severe obesity.