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An appendectomy (sometimes called appendisectomy or appendicectomy) is the surgical removal of the vermiform appendix. This procedure is normally performed as an emergency procedure, when the patient is suffering from acute appendicitis. However, a 12-hour delay had no effect on outcomes, in a large retrospective study. In one large observational study in 2003, 30-day mortality was 1.8% in an adult population. Appendectomy may be performed laparoscopically (in minimally invasive surgery) or as an open operation. Laparoscopy is often used if the diagnosis is in doubt, or if it is desirable to hide the scars in the umbilicus or in the pubic hair line. Recovery may be a little quicker with laparoscopic surgery; the procedure is more expensive and resource-intensive than open surgery and generally takes a little longer, with the (low in most patients) additional risks associated with pneumoperitoneum (inflating the abdomen with gas). Advanced pelvic sepsis occasionally requires a lower midline laparotomy. ==Procedure== In general terms, the procedure for an open appendectomy is: #Antibiotics are given immediately if signs of sepsis are seen; otherwise, a single dose of prophylactic intravenous antibiotics is given immediately before surgery. #General anaesthesia is induced, with endotracheal intubation and full muscle relaxation, and the patient is positioned supine. #The abdomen is prepared and draped and is examined under anesthesia. #If a mass is present, the incision is made over the mass; otherwise, the incision is made over McBurney's point, one-third of the way from the anterior superior iliac spine to the umbilicus; this represents the position of the base of the appendix (the position of the tip is variable). #The various layers of the abdominal wall are opened. #The effort is always made to preserve the integrity of abdominal wall. Therefore, the external oblique aponeurosis is split along the line of its fibers, as is the internal oblique muscle. As the two run at right angles to each other, this reduces the risk of later incisional hernia. #On entering the peritoneum, the appendix is identified, mobilized, and then ligated and divided at its base. #Some surgeons choose to bury the stump of the appendix by inverting it so it points into the caecum. #Each layer of the abdominal wall is then closed in turn. #The skin may be closed with staples or stitches. #The wound is dressed. #The patient is brought to the recovery room. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Appendectomy」の詳細全文を読む スポンサード リンク
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