From: Interventions in randomised controlled trials in surgery: issues to consider during trial design
Components | Definition | Description | Steps within each component |
---|---|---|---|
 |  |  | Two further 0.5-cm incisions in the left iliac fossa and suprapubic regions. |
Separation and incision of the fat, fascia, muscular layers and peritoneum. | Identification of the base of the umbilicus. | ||
Incision of fascia using a knife and peritoneum using scissors. | |||
Creation of a pneumoperitoneum | Insertion of the laparoscopic ports (through fascia and peritoneum). | ||
Insufflation of gas into the abdomen. | |||
Dissection of the appendix | The process of exposing an organ, tissue or structure | Dissection of tissues surrounding the appendix. | Use of a laparoscopic hook and diathermy to dissect the appendix from surrounding tissues. |
Isolation and ligation of the blood supply. | Use of hook diathermy to divide the mesoappendix and coagulate the artery. | ||
Resection of the appendix | Removal of all or part of an organ, tissue, or structure | Securing the appendix base with staples/sutures. | Application of sutures to the base of the appendix. |
Division of the base of the appendix. | Cutting of the appendix from its base with laparoscopic scissors. | ||
Removal of the appendix from theabdomen. | Placement of a bag into the abdomen within which to retrieve the appendix through a laparoscopic port. | ||
Closure of the abdomen | Closure of the abdominal layers | Closure of the peritoneum, fascia and skin. | Closure of the fascia at the umbilical port site using a box stitch. Closure of the skin at all three port sites, using sutures or steri-strips. |