TAC 27 May-Jul96

TAC 27 Index

Advertisement feature - The Bolt-On Appendicectomy Kit

The Bolt-On(tm) Corporation are pleased to announce the first in their range of soft-tissue surgical kits. Now you needn't let that niggling appendicitis cut short your camping holiday!


Here's how to use it:

Give the anaesthetic. Sit up with your legs straight in front of you. (Choose a comfortable spot, because you are going to be spending the next few hours here!) Lift your clothing at the back to expose the "nobbles" of your spinal column. Set up the Bolt-On(tm) Rear-Vue Mirrors so that you can get a clear view of the area without straining. Select the appropriate spinal needle from the Kit: choose from the Slim, Standard or Full-Figured lengths. Lay out the preloaded syringe of local anaesthetic where you can reach it quickly. Now: push the needle firmly into your back, between two bony nobbles, keeping carefully to the midline, and angling a little upwards. You will feel a stiff resistance at first, but after a couple of inches there should come a distinct "give" or "pop". This may be accompanied by a "shooting" or "searing" sensation down one leg. Watch the outer end of the needle carefully - clear fluid should now appear and drip out quite briskly. This is cerebrospinal fluid, and you should not let too much leak away, or you may develop "dry brain" side-effects. Just reach carefully for the local anaesthetic syringe, while bending your back as little as possible. Now attach it to the end of the needle, and inject its contents. Remove the syringe and needle together.

Wait for the anaesthetic to work. Don't rush straight into your operation! Lie down flat, with your head propped up on a bed-roll or walking boot. While you wait for your legs to become paralysed, adjust the mirrors to obtain a clear view of your lower abdomen. Lay out the scalpel, forceps and clamps on a clean, dry surface such as the cover of a magazine or a strip of toilet paper. Has your tummy become numb and "rubbery" to the touch? Well then, let's begin!

Mark the site. Stretch the paper tape provided from your tummy button to your hip bone, and then use the felt-tipped pen to mark a point a third of the way in from the hip. Now draw the line of your incision at right angles to the tape at this point. Make it a good three inches long; at least enough to admit two or three of your own fingers.

Now begin! Take a deep breath, then cut firmly from one end of your felt-pen mark to the other. Be positive! Don't make multiple shallow "slices", as these will heal into an unsightly scar later. Expect some blood, and dab it away with the swabs. Beneath a layer of fat, you'll find three layers of muscle: cut through each layer along the line of the muscle fibres. Now be careful! Beneath the next thin, fibrous layer lies your large bowel, and you don't want to make a hole in that! Snip through carefully with the scissors.

Get out the appendix. Push two fingers gently into your abdomen, until you can feel bowel moving under your fingers. Search patiently for a thin, worm-like structure. (Don't rush - you have three hours before the anaesthetic wears off.) When you find it, grip it firmly and lift it out through the incision. Breath gently, and try not to cough or strain at this point, since bowel might "erupt" through the wound. If this does occur, remain calm. Try to stop loops of bowel spilling on to the ground, and then gently tuck them back through the incision, a loop at a time. If the bowel is contaminated by peat or heather, brush off the worst soiling, and be sure to take the broad-spectrum antibiotic provided in the Bolt-On(tm) Surgical Emergencies Add-On Pack (not included).

Staple and cut! It's that easy with the Bolt-On(tm) Appendicectomy Tool. Slip it around the appendix at the point where it joins the large bowel. Pull Trigger 1 to safely staple the appendix base, then pull Trigger 2 to guillotine the appendix. (Note: The Bolt-On(tm) Corporation can accept no responsibility for peritonitis, septic shock or fistula formation if the recommended trigger order is reversed.)

Close up. Tuck the remaining bowel away, then stitch up the abdominal lining, muscles and skin, taking care to use the stitch pack marked "Dissolving" for the internal layers. You're done! Congratulations! Now just wait for the feeling to return to your lower body.

Note: In preparation for returning sensation, you may wish to lay out the syringe marked "Morphine" from the Bolt-On(tm) Surgical Emergencies Add-On Pack (not included).

TAC 27 Index