Mayo stand and back table instruments for Laparoscopic Appendectomy surgery setup

Clamping & Occluding

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  Laparoscopic Clip Appliers

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  Curved Hemostat

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  Kelly Forceps

Cutting & Dissecting

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  L Hook Cautery

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  #3 Knife Handle

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  Laparoscopic Metz Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Toothed Forcep

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  Standard Laparoscopic Grasper

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  Laparoscopic Babcock Forceps

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  Laparoscopic Hunter Bowel Grasper

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  Laparoscopic Wave Grasper

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  Laparoscopic Fenestrated Grasper

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  Adson Forceps

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  Non toothed Pickup

Misc

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  Laparoscope

Retracting & Exposing

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  Army-Navy Retractor

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  Hasson S Retractor

Suctioning

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  Suction Irrigator

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  Yankauer Suction

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Laparoscopic Appendectomy

Surgery Steps: The scalpel will be used to make approximately 3-4 incisions to insert trocars. A Verres needle may be used to introduce CO2 into the abdomen. With this method, a Kelley and two towel clips should be available to insert the Verres needle. A syringe of saline may also be needed after inserting the Verres needle. S retractors or Army-Navys may be used to retract to insert trocars.

Another method is to insert a trocar, and then attach the CO2 tubing, achieving pneumoperitoneum. Fat or adhesions can be dissected with graspers, hook cautery, and Maryland. Once dissected, the cecum will be found using an instrument that won’t cause damage, and the appendix will be at the end of it. Using a laparoscopic stapler, the appendix as well as the artery in the appendix will be ligated and the appendix will then be amputated. The stump left behind from the appendix is then usually cauterized to avoid bleeding.

Another way of amputating the appendix is to use a suture loop, and then laparoscopic scissors. The appendix will then be removed through one of the trocars. CO2 gas in released from the abdomen, and the trocars will then be removed, and the port sites will be closed. A needle driver and an adson pick-up will be needed for suturing, and the straight mayo scissors should be available for cutting suture. 

Instruments:
Misc: Verres needle, Endopouch, Endoloop, Culture Tubes

Extra Equipment:
ESU, suction, CO2 tubing, camera, light cord, trocars, video monitors, 

Drapes: Folded towels, laparotomy drape

Notes: An endopouch may be used if the appendix is inflamed. Cultures may be taken depending on severity. Isolate instruments that come in contact with the amputated appendix to preserve sterility.