Classic intraop questions in appendectomy

Question 1

What is the difference between a McBurney’s incision and a Rocky-Davis incision?

Answer 1

Mcburney is angled down (follows oblique fibers)

Rocky-Davis is straigh accross(transverse)

Question 2

What are the layers of the abdominal wall during a McBurny incision

Answer 2

1. Skin
2. Subcutaneous fat
3. Scapra’s fascia
4. External Oblique
5. Internal Oblique
6. Transversus muscle
7. Transversalis fascia
8. Preperitoneal fat
9. Peritoneum

Question 3

Which way should you finger sweep trying to find the appendix?

Answer 3

Lateral to medial along the lateral peritoneum - so you wont tear the mesoappendix that lies medially!

Question 4

Who first described the classic history and Tx for Acute AP

Answer 4

Reginald Fitz

Question 5

Who performed the first AP?

Answer 5

Harry Hancock

Question 6

What is the most common appendiceal tumor?

Answer 6

Carcinoid tumore

Question 7

What is the treatment of appendiceal carcinoid less than 1.5cm?

Answer 7

AP

Question 8

What is the treatment of appendiceal carcinoid more than 1.5cm?

Answer 8

Right hemicolectomy

Question 9

What percentage of appendiceal carcinoids malignant?

Answer 9

<5%

Question 10

What is the differential diagnosis of eppendiceal tumor?

Answer 10

Carcinoid, adenoCA, malignant mucoid adenoCA

Question 11

What is “mittelschmerz”?

Answer 11

Pelvic pain caused by ovulation