Laparoscopic appendectomy for mucocele of the appendix
A 60-year-old female presented with pain in lower part of abdomen and palpable tender lump in the right ileac fossa. Ultrasound of the abdomen reports a cystic mass of size 12 × 15 cm with thin internal septations in the right adnexa. Her hemogram and biochemistry were within normal levels. We planned for diagnostic laparoscopy and further treatment. The pneumoperitoneum was created with veress needle using carbon dioxide and the pressure was kept at 11 mmHg. The table was kept in the Trendelenburg position with 15° left tilt. A 0° telescope was introduced through the umbilical port for the complete examination of the abdomen. Diagnostic laparoscopy revealed approximately 14 × 15 cm large bluish mucocele of the appendix with omental adhesions. The ovary, fallopian tube, and uterus were all normal looking. Two 5-mm ports were placed in the supra pubic area below the pubic hair line as the working port. The mucocele of the appendix was isolated after separating the mesoappendix from it with the help of bipolar cautery. Following this, the base of the appendix was ligated at the ileocecal junction and divided. Mucocele of the appendix [] was retrieved out in a plastic bag through the umbilical port. Hemostasis was obtained and a suction drain left in situ which was removed when non-productive. The umbilical port site wound was closed with 1.0 Vicryl. Cut section showed appendix was filled with mucin-like material []. She was started orally after 4 hours of operation and solid food on the next day. She was called for a revisit after a week for follow up.