MEDICAL ANIMATION TRANSCRIPT: Removal of the appendix, called appendectomy, is performed when appendicitis is suspected. Right lower abdominal pain, fever, and elevated white blood cell count are common symptoms and signs of appendicitis, which usually occurs when a blockage develops between the appendix and the intestine. This leads to infections, swelling, and distension. If the appendix is not removed it can lead to a life threatening perforation or rupture. The most common treatment for appendicitis is appendectomy, which is almost always performed on an emergency basis. Laparoscopic techniques require only tiny keyhole incisions or puncture wounds. To get inside your abdomen, your surgeon will make a small keyhole incision near your belly button, known as an umbilical port, with a tube called a trocar. Gas will then be pumped through this port to puff up your abdomen so its contents can be viewed more easily. Next, your surgeon will insert a laparoscope through this port. The laparoscope is a thin tube with a tiny camera on the end of it that projects images onto a monitor to guide your surgeon's work. Using the laparoscope, your surgeon will examine images of your appendix on the monitor to confirm that it's red and swollen. If your appendix needs to be removed, additional ports will be created. Your surgeon will pass surgical instruments through these other ports to grasp the appendix. Another instrument will be used to separate the appendix from the intestine and close the ends with staples. The appendix will be placed into a specimen bag and removed through one of the ports. At the end of the procedure, the laparoscope and surgical instruments will be removed. A port valve will be left in place briefly to allow the gas to escape from the abdomen. The incisions will be closed with sutures, followed by skin glue or skin closure tape. If your appendix can't be removed laparoscopically, your surgeon will switch to an open procedure. Reasons for switching to an open procedure include-- an extensive infection or abscess, a perforated appendix, which means there is a hole in it, obesity, dense scar tissue from previous abdominal surgery, difficulty viewing the organs with the laparoscope, and bleeding problems during the operation. An open appendectomy is done directly through a slightly larger abdominal incision over your appendix or through a lower midline incision as needed. The surgeon will tie off the appendix with sutures and remove it. Then, the incision will be closed with sutures or staples.