Colorectal

Appendicectomy (Open)

APPENDICECTOMY (OPEN)

Indication: Acute appendicitis or diagnostic uncertainty requiring appendiceal removal. Open approach used when laparoscopy is unavailable, in advanced peritonitis, or where conversion from laparoscopic approach is required.

Patient Position: Supine.

Anaesthesia: General.

Prophylactic Antibiotics: Broad-spectrum coverage for colonic flora (second-generation cephalosporin or co-amoxiclav with metronidazole). Extended if perforated.

Incision: Gridiron (muscle-splitting) incision centred on McBurney's point in the right iliac fossa. Alternatively, lower midline for advanced peritonitis or diagnostic uncertainty.

Procedure:
1. Incision through skin and subcutaneous tissue. External oblique, internal oblique, and transversus abdominis muscles split in the direction of their fibres. Peritoneum opened.