Setup for a Laparoscopic Appendectomy (Kingsborough Community College, Brooklyn, NY)

Correct preoperative setup of the sterile field, including surgical instrumentation, is critical to ensure patient safety and optimize surgical outcomes. Educational videos such as this provide important resources for surgical technology students and other healthcare professionals who are learning how to master these foundational skills. This video demonstrates a complete setup of the back table and Mayo stand for a laparoscopic appendectomy, during which all instruments are identified and counted in accordance with established safety protocols. The setup process includes verification of sterile indicators to confirm sterility, followed by a systematic count of soft goods and sharps and identification of specialized laparoscopic instrumentation.

Appendectomy is the most commonly performed emergency surgical procedure. Although laparoscopic appendectomy is generally preferred, appendectomy is performed by both open and laparoscopic methods depending on patient factors, surgeon expertise, and resource availability. However, since gaining widespread adoption in the 1990s, the laparoscopic technique has demonstrated clear advantages over open appendectomy, including reduced postoperative pain, shorter hospital stays, and faster return to normal daily activities.^1,2

The annual incidence of appendicitis is 233 patients for every 100,000 people in the population, while the risk of developing appendicitis throughout one’s life averages between 6.7% and 8.6%.^3,4 In addition to surgical expertise, positive patient outcomes also depend on careful, comprehensive perioperative preparation and strict adherence to established safety protocols.

This video presentation demonstrates a method for preparing the back table, Mayo stand, and ring stand for a laparoscopic appendectomy. Before placement of the instrument tray on the back table, sterile indicators are examined jointly by the surgical technologist and the circulating nurse to confirm that sterilization parameters have been met. The back table and ring stand have been sterilely draped. Patient drapes, along with gowns and gloves for the surgical team, are kept in the ring stand. Patient draping will follow a specific sequence, beginning with a three-quarter drape, followed by four adhesive drapes to square off the incision site. The laparoscopic drape is placed last.

The initial surgical count is a mandatory safety protocol designed to prevent retention of foreign objects. Soft goods (sponges), sharps, surgical instrumentation, and other items such as a marking pen are included in the initial count. All counted items are documented by the circulator on the surgical count sheet.

Laparoscopic instruments may or may not be included in the initial count; be sure to follow the rules at your institution. The laparoscopic instruments shown in this video include:

• Maryland dissector: used for blunt and sharp dissection of tissue planes.
• Atraumatic graspers: used for tissue manipulation while minimizing tissue injury.
• Laparoscopic scissors: dedicated instruments for cutting tissue and sutures within the peritoneal cavity.
• Laparoscopic cautery: an electrosurgical instrument with an angled tip for coagulation.
• Biopsy forceps: used for obtaining tissue samples when indicated.

The Mayo stand is organized with scissors, clamps, forceps, an electrocautery device, and other essential items, including insufflation tubing, a light handle cover, 0° laparoscopes, trocars, a Veress needle, and a scope warmer to prevent fogging. Scalpel blades are loaded onto knife handles using a needle holder to minimize the risk of injury. Surgical gowns and patient drapes are arranged for easy access.

This laparoscopic appendectomy setup ensures that all necessary instruments and devices are prepared, organized, and counted before the procedure begins. Studies have shown that video-based instruction achieves learning outcomes comparable to traditional hands-on demonstrations while offering consistent, reproducible, and accessible training experiences. This video helps students by offering a comprehensive visual guide to preparing the sterile field for a laparoscopic appendectomy.

Nothing to disclose.