Laparoscopic appendectomy




K Laparoscopic appendectomy




1. Introduction

Appendectomy is performed for acute appendicitis, and a laparoscopic approach is most commonly used.



2. Preoperative assessment and patient preparation
a) History and physical examination
(1) Gastrointestinal: Patients point to localized pain at McBurney point, which is midway between the iliac crest and umbilicus; rebound tenderness, muscle rigidity, and abdominal guarding are noted.

(2) Pregnancy: Alder sign is used to differentiate between uterine and appendiceal pain. The pain is localized with the patient supine. The patient then lies on his or her left side. If the area of pain shifts to the left, it is presumed to be uterine.

b) Diagnostic tests
(1) The white blood cell count is elevated, with a shift to the left: 10,000 to 16,000 mm3; 75% neutrophils. Increased body temperature may indicate ruptured appendix and septicemia.

(2) Urinalysis shows a small number of erythrocytes and leukocytes.

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Dec 2, 2016 | Posted by in ANESTHESIA | Comments Off on Laparoscopic appendectomy

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