This woman presented with appendicitis at 27 weeks gestation. The patient was turned in the right side up lateral postion to rotate the uterus away and bring the appendix anteriorly. Three ports were placed in the right flank. The procedure was done wit
A. Division of the appendiceal base using pretied sutures. B. Division of the base using the endoscopic stapling device.
The mesoappendix is divided serially with clips, ligatures, or other hemostatic devices. Both the endoscopic stapler and the ultrasonic scalpel may also be used for this purpose.
A pretied ligature may be used to elevate a grossly inflamed appendix with minimal trauma.
Trocar placement for laparoscopic appendectomy. The laparoscope is inserted through an umbilical port. A second trocar (5 or 10 mm) is placed in the suprapubic region and used to elevate the appendix. The third trocar is the working port and should be pla