Twenty Minutes of an Appendectomy

In practice

The incision is made low on the patient's right. Jordan, the scrub person, has the next steps in mind. As the surgeon divides the tissue under the skin, Jordan passes small clamps for bleeders, then the electrosurgical pencil, and has a sponge ready. The surgeon asks for retractors; Jordan passes a pair suited to the shallow depth, with the blades facing the right way. Deeper, the surgeon finds the appendix and asks for a clamp to hold it gently; Jordan passes a Babcock, the atraumatic clamp for bowel, rather than a toothed one. When the base of the appendix is ready, Jordan has a right angle clamp and a tie loaded before they are asked for, then passes straight Mayo scissors to cut the tie. A small vessel bleeds; Jordan passes suction first, then a clamp, then another tie. Each sponge that goes into the wound, Jordan notes; each that comes out, Jordan hands off to be bagged. The appendix is removed and placed in a specimen container that Jordan labels at once and hands off to the circulating nurse. As the surgeon irrigates, Jordan sets out the closing sutures in the order of the layers and tells the circulating nurse it is time for the closing count.