Mayo stand and back table instruments for Appendectomy surgery setup

Clamping & Occluding

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  Curved Hemostat

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  Right Angle Clamp

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  Kocher Forceps

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  Kelly Forceps

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  Straight Hemostat

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  Tonsil Clamp

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  Babcock

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  Allis Forceps

Cutting & Dissecting

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  #3 Knife Handle

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  Metzenbaum Scissor

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  Curved Mayo Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Toothed Forcep

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  Smooth Adson

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  Adson Forceps

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  Forester Sponge Forceps

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  Non toothed Pickup

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  Debakey Forceps

Retracting & Exposing

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  Freer Skin Hook

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  Army-Navy Retractor

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  Senn Retractor

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  Richardson Retractor

Suctioning

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  Yankauer Suction

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Appendectomy

All of the cords and suction will be passed off after draping the patient. The surgeon will stand on the side where they are making an incision, and the tech will be on the opposite side with their Mayo stand and table.

Surgery Steps: Usually a McBurney incision is made in the lower right abdomen with a 15 blade loaded onto a #3 knife handle. The doctor will then dissect down to the appendix using the bovie, metzenbaum scissors, DeBakey pickups, toothed pickups, tonsils, and possibly hemostats. For retraction, a small incision will most likely require Army-Navys or small Richardsons. The appendix will then be found after the dissection, and any possible vascular structures will be ligated.

I always keep free ties available close by in case of any unexpected bleeding.

An absorbable suture such as Vicryl or silk will be tied at the base of the appendix, and the appendix will then be removed, usually using scissors, harmonic scalpel, or a stapler. The remaining stump is usually cauterized, or left alone as long as no bleeding is occuring. The doctor may also use a purse string suture.

Closure will then begin with a Mayo begat needle driver, debakeys, adsons with teeth, and straight Mayo scissors after irrigating the incision, and proceed in layers until the skin is reached last. The deepest layer will be closed using usually a vicryl suture, and the skin is usually closed using a non absorbable suture such as a nylon or monocryl that can be taken out a couple weeks/days later after healing.

Extra Equipment: ESU, suction 

Appendectomy Drapes: Folded towels, laparotomy drape

Notes: Cultures may be taken, so test tubes should be available for that. Any instruments that are touching the appendix when it is removed should be kept in a separate area to avoid contaminating the rest of the sterile field.