Appendoectomy

property of minos medical inc - all rights reserved 2007©

The Appendoectomy procedure


1. Overtube is pre-loaded on the colonoscope

1. Overtube is pre-loaded on the colonoscope

Procedural Sequence


Navigation Mode

Procedural Sequence

2. Colonoscope is maneuvered to the caecum with the Overtube in the retracted position

2. Colonoscope is maneuvered to the caecum with the Overtube in the retracted position


Procedural Sequence

3. Caecum is imaged once it is reached by the colonoscope

3. Caecum is imaged once it is reached by the colonoscope


Procedural Sequence

4. Manipulator Device is introduced via the working channel over the guidewire

4. Manipulator Device is introduced via the working channel over the guidewire


System in the caecum with catheter in the appendix

System in the caecum with catheter in the appendix


Guidewire

Depth Markers

Manipulator Device

Procedural Sequence

5. Manipulator Device is inserted into the appendix using the guidewire to cross the ostium(Balloon dilation is often required)

5. Manipulator Device is inserted into the appendix using the guidewire to cross the ostium(Balloon dilation is often required)


Procedural Sequence

6. Appendix is irrigated to remove fecal & other foreign matter

6. Appendix is irrigated to remove fecal & other foreign matter


Procedural Sequence

7. Guidewire is replaced with stylet to perform manipulation to assess mobility of the appendix

7. Guidewire is replaced with stylet to perform manipulation to assess mobility of the appendix


Procedural Sequence

8. Overtube & Inverter Catheter are advanced over the scope

9. Guidewire is placed through the ostium

8. Overtube & Inverter Catheter are advanced over the scope

9. Guidewire is placed through the ostium


Procedural Sequence

10.Inverter Catheter is inserted

11.Overtube is advanced against caecal wall to provide counterforce

12. Sealing Sleeve is advanced over the unused vacuum holes

10.Inverter Catheter is inserted

11.Overtube is advanced against caecal wall to provide counterforce

12. Sealing Sleeve is advanced over the unused vacuum holes


Procedural Sequence

13.Vacuum is applied

14.Appendix inverts “From the base” as the catheter is retracted

15.Cautery is utilized to dissect the wall to aid tissue inversion

13.Vacuum is applied

14.Appendix inverts “From the base” as the catheter is retracted

15.Cautery is utilized to dissect the wall to aid tissue inversion


Procedural Sequence

16.Inversion is completed

17.Ligature is cinched17.Ligature is cinched


Snare

Procedural Sequence

18.Polypectomy snare is advanced via the working channel to perform resection

18.Polypectomy snare is advanced via the working channel to perform resection


Scissors

Snare captures appendix

Procedural Sequence

19.Suture tail is trimmed & the polypectomy snare is used for appendix retrieval

19.Suture tail is trimmed & the polypectomy snare is used for appendix retrieval


Procedural Sequence

20.Appendix is removed leaving the Overtube in place

20.Appendix is removed leaving the Overtube in place


Procedural Sequence

21.Colonoscope is reinserted

22.Overtube and scope are removed under direct visualization

21.Colonoscope is reinserted

22.Overtube and scope are removed under direct visualization

Appendoectomy

Health & Medicine

Transcript of Appendoectomy