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Laparoscopic Interval Appendectomy and Open Umbilical Hernia Repair

John Grove1; Naomi Sell, MD2; Thomas O'Donnell, MD2; Noelle N. Saillant, MD2
1Lincoln Memorial University – DeBusk College of Osteopathic Medicine
2Massachusetts General Hospital

1. Introduction

2. Draping

3. Gain Laparoscopic Access via Cut Down Technique at Umbilicus

4. Dissection

  1. Identify Cecum and Appendix
  2. Adhesiolysis
  3. Make Window into Mesentery at Junction with Cecum

5. Transect Base of Appendix from Cecum with Abdominal Load Stapler

6. Remove Appendix

  1. Mobilize Appendix
  2. Divide Mesentery and Blood Supply with Vascular Load Stapler
  3. Inspect for Hemostasis Along Staple Lines
  4. Place in Specimen Bag and Remove from Abdomen
  5. Remove Ports and Desufflate Abdomen

7. Umbilical Hernia Repair

  1. Identify Hernia Defect
  2. Amputate Stalk Completely
  3. Remove Hernia Sac
  4. Repair Opening in Fascia
  5. Reattach Umbilical Stalk to Fascia

8. Closure

9. Post-op Remarks