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General Surgery > Lap Appendectomy > Flashcards

Lap Appendectomy Flashcards

1
Q

Surgical Anatomy & Pathology

A

. Attached to cecum by the mesoappendix, which contains the appendices artery
. Frequently located upward & inward, behind the cecum called retrocecal
. Inflamed, infected appendix called appendicitis; often due to impacted feces

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2
Q

Preoperative Diagnostic Tests & Procedures

A

. Physical exam
. CT scan
. Laboratory test

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3
Q

Equipment & Instruments Unique to Procedure

A

. Laparoscopic equipment
. 5-mm trocar
. Hasson trocar (available according to surgeon’s preference)
. Laparoscopic instruments to include Babcock, curved grasping forceps, curved scissors, endoscopic linear stapler, ligating loop instrument, needle holder, suction irrigator, and bowel clamp

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4
Q

Supplies Unique to Procedure

A

. Specimen puch
. Local anesthetic of the surgeon’s choice for tracer sites

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5
Q

Preoperative Preparation

A

. Position: Supine w/ slight Trendelenburg & right side of OR table slightly elevated
. Anesthesia: General
. Skin Prep: Mid-chest to symphysis pubis & laterally as far as possible
. Draping: Square off with 4 towels-edge of upper towel placed mid-chest; lateral towels placed using anterior superior iliac spines as guide; edge of lower towel placed just above line of sympysis pubis; laparotomy drape

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6
Q

Practical Considerations

A

. Same as for other laparoscopic procedures
. Monitor will need to be placed at the foot of the bed with the surgeon standing near the head of the bed
. Be prepared to convert to open procedure if the appendix is ruptured or leaking upon visualization with laparoscope

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7
Q

Surgical Procedure #1

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8
Q

Surgical Procedure #1a

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9
Q

Surgical Procedure #1b

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10
Q

Surgical Procedure #2

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11
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Surgical Procedure #3

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12
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Surgical Procedure #4

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13
Q

Surgical Procedure #5

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14
Q

Surgical Procedure #6

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15
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Surgical Procedure #7

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16
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Surgical Procedure #10

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17
Q

Surgical Procedure #8

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18
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Surgical Procedure #9

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19
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Surgical Procedure #11

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19
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Surgical Procedure #12

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20
Q

Surgical Procedure #13

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21
Q

Surgical Procedure #15

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22
Q

Surgical Procedure #14

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23
Q

Postoperative Considerations: Immediate Postoperative Care

A

. Transport to PACU

23
Q

Surgical Procedure #16

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24
Q

Postoperative Considerations: Prognosis

A

. No complications: Discharged same day of sx; return to normal activities in 2-4 weeks
. Complications: Hemorrhage; SSI; intestinal obstruction due to postoperative adhesions forming appendiceal stump rupture; sepsis

25
Q

Postoperative Considerations: Wound Classification

A

. Class 2: Clean Contaminated

General Surgery (30 decks)

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