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Laparoscopic appendectomy for appendicitis with peritonitis
This is the case of a 37-year-old male patient who presented with abdominal pain and fever at 39.4°C. The work-up demonstrated important inflammation with leukocytes at 16,000 and CRP levels at 169. CT-scan confirmed an acute appendicitis with an appendicolith at the base. The appendix is probably perforated as the CT-scan also demonstrated a pneumoperitoneum. Laparoscopic appendectomy is decided upon. The operative set-up is standard with an optical port placed at the umbilicus, a port in the left iliac fossa, and a suprapubic port. Exposure, appendectomy with stapling of the appendicular base, and cleansing of the peritoneal cavity are thoroughly demonstrated.
M Ignat, D Mutter, J Marescaux
Surgical intervention
1 year ago
4284 views
474 likes
0 comments
05:03
Laparoscopic appendectomy for appendicitis with peritonitis
This is the case of a 37-year-old male patient who presented with abdominal pain and fever at 39.4°C. The work-up demonstrated important inflammation with leukocytes at 16,000 and CRP levels at 169. CT-scan confirmed an acute appendicitis with an appendicolith at the base. The appendix is probably perforated as the CT-scan also demonstrated a pneumoperitoneum. Laparoscopic appendectomy is decided upon. The operative set-up is standard with an optical port placed at the umbilicus, a port in the left iliac fossa, and a suprapubic port. Exposure, appendectomy with stapling of the appendicular base, and cleansing of the peritoneal cavity are thoroughly demonstrated.
Benefit of laparoscopic approach in an appendicular purulent peritonitis
This video is one of a series of laparoscopic appendicectomies and shows the advantage of the videoscopic approach in accessing the entire peritoneal cavity in cases of diffuse peritonitis.
Blood tests revealed an inflammatory syndrome in a young woman with a 3-day history of diffuse abdominal pain and fever. Exploration of the abdominal cavity during emergency laparoscopy confirmed the clinical impressions. The authors performed aspiration and lavage of the peritoneal cavity. Thorough assessment revealed the omentum to be concentrated in the right iliac fossa, and gentle dissection uncovered a necrotic, perforated appendix. Dissection of the cecum and appendix was difficult because the tissues were friable and adherent. The usual tissue planes were not present, but the laparoscopic view allowed for a safe approach.
F Costantino, J Marescaux
Surgical intervention
11 years ago
745 views
100 likes
0 comments
04:04
Benefit of laparoscopic approach in an appendicular purulent peritonitis
This video is one of a series of laparoscopic appendicectomies and shows the advantage of the videoscopic approach in accessing the entire peritoneal cavity in cases of diffuse peritonitis.
Blood tests revealed an inflammatory syndrome in a young woman with a 3-day history of diffuse abdominal pain and fever. Exploration of the abdominal cavity during emergency laparoscopy confirmed the clinical impressions. The authors performed aspiration and lavage of the peritoneal cavity. Thorough assessment revealed the omentum to be concentrated in the right iliac fossa, and gentle dissection uncovered a necrotic, perforated appendix. Dissection of the cecum and appendix was difficult because the tissues were friable and adherent. The usual tissue planes were not present, but the laparoscopic view allowed for a safe approach.