Editing Appendicectomy (section)

== Open appendicectomy ==

* Mark a line between ASIS and     umbilicus, and mark Mcburney's point 1/3 of the way to umbilicus
* Make 5cm incision at     McBurney's point along Langer's lines
** Can also do Rockey-Davis      (transverse) incision
* Carry incision down to     aponeurosis of external oblique, and divide in direction of fibres to     expose internal oblique
* Divide IO and expose     transversus abdominis, which is split to expose peritoneum
* Elevate peritoneum and divide     with Metz scissors
* Identify caecum and appendix
* Divide mesoappendix between     two Kelly clamps and tie off
* Ligate appendix and divide
* No need to invert the stump
* Close in layers: first     peritoneum and transversalis, then IO, then EO, then skin



Drains only necessary for abscess cavities