Narrated Dipes appy

This modification of single site appendectomy allows for 90 degree retraction using two umbilical ports (either 2.5 mm or 2 mm and 4 mm) through a 10 mm incision and a single 3 mm port in the suprapubic area below the bikini line.

The small suprapubic incision results in an almost scarless defect.

A 4 mm 30 degree lens is used for the procedure and the Maryland dissector has almost complete range of motion without conflict with the scope.

A 5 mm hook is generally adequate to take the appendiceal mesentery in almost all cases.

The mesentery is addressed near the base of the appendix to prevent excess cauterization and re-cauterizing the appendiceal artery numerous times.

This procedure took just 10 minutes and the video is relatively unedited.

The base of the appendix is compressed to ensure there is no fecolith at the base and that the tissue is adequately compressible to allow for use of the 5 mm stapler.

It is important to apply the 5 mm stapler and allow it to compress for a full 10 seconds prior to firing to allow the 2 mm staplers to adequately get through the tissue and provide a safe seal.

The 5 mm endoscopic specimen bag does not fit through a true 5 mm port.

The 5 and 4 mm trocar sites are connected to remove the specimen through the umbilical site.

At 2 weeks postoperatively, the scars are almost scarless.