Appendectomy is the surgical removal of the appendix when an infection has made it inflamed and swollen. This infection, called appendicitis, is considered an emergency because it can be life threatening if untreated. Occasionally, an inflamed appendix burst after a day of symptoms. The appendix is so close to the large intestine, that it could become clogged with stool and bacteria. Other times mucus produced by the appendix can thicken and cause a blockage. In both cases, once the opening to the appendix is congested, it can become inflamed and swollen causing appendicitis. So it’s very important to have it removed as soon as possible.
Appendicitis can cause sudden pain in the middle of the abdomen, usually concentrated around the umbilical area. The pain often moves to the lower right iliac of the abdomen. At first pain might come and go, and then it becomes persistent and sharp. Appendicitis may also cause; loss of appetite, fever, nausea, vomiting, diarrhea, and frequent painful urination. The appendix is located in the abdomen. The appendix is a small organ connected to the cecum in the large intestine. The appendix is a worm like blind tube, 0.8 cm wide and averaging 8.5 to 22.5 cm in length. The appendix derives blood supply from the mesoappendix. One end of the appendix is closed and the other opens into the large intestine, the organ that absorbs water from waste (stool) and moves it out of the of the body through the anus.
Equipment used during an appendectomy includes: Suction apparatus, headlamp available, and the electrosurgical unit with dispersive electrodes. (Frey, 2008 pg.435) Supplies needed during procedure include: Prep set, basic pack, basin set, blades (3) # 10, needle magnet or counter, antiembolitic hose if requested, ice pack if patient has an elevated temperature, Culture tubes (aerobic and anaerobic), electrosurgical pencil. Penrose drain, irrigation solution, gloves, sutures according to surgeon’s preference, laparotomy drapes, and dressing material according to surgeon’s preference.
The patient is placed in a supine position; arms may be extended on a padded arm board at less than 90 degree angle to the body. A pad may be placed under the sacrum or under the knees to avoid back strain.
For an appendectomy a minor instrument set is used. This include: Yankauer suction tip, #3 knife handle, Mayo scissors straight, Mayo scissors curved, 7” Metzenbaum, Adson with teeth forceps, Mosquito curved forceps, Crile forceps 5 ½
Curved, Backhaus towel clamps, Foerster Sponger forceps, Mayo Hegar needle holder 6”, U.S Army/Navy retractor, Allis tissue forceps 6”, Babcock tissue forceps 6 ¼ , Probe with eye 5 ½, Senn rake retractor, Volkman retractor, Frazier Ferguson suction tip, Schnidts hemostatic forceps. (Frey, 2008 pg. 408)
The back table is set up with a basin and an appendectomy minor set with all accountable supplies. Examples of accountable supplies include sponge sticks, kittners/boots, Penrose, vessel loops, sutures, knifes blades, hypos, bovie tips, scratcher ect,. An appendectomy minor tray is place on the center of the table leaving enough space for any additional supplies or items that may be needed during the procedure.
The mayo stand is draped with a mayo draped and a towel is placed on top of the mayo. A roll towel is placed on the mayo for the following instrumentation: #3 knives handle with a #10 knife blade, 4-Kellys Curved, 4-Peans, 2-Kockers, 2- Allis, 2-Tonsils, Metzabaum scissors, Mayo Tissue & Mayo Suture scissors, 2-Adson with teeth forceps, 2-Debakey forceps, and 2-Goelet retractors.
Irrigation solution 0.9 % sodium chloride is used for irrigation....
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