is Transconic Endoscopic Appendectomy for Stomach Appendicitis. The short title is T for Stomach Appendicitis. These are our disclosures. As we know, Transconic Endoscopic Appendectomy has been reported as an alternative procedure for appendicial office lesions, including chronic sensor-serrated lesions, appendicial retention cysts, appendicial polyps, and chronic appendicitis. Here we present T as a novel technique for minimally invasive treatment of stomach appendicitis. This is a 78-year-old female patient. Her chief complaint was about recurrent lower right abdominal pain. Eight years ago, she underwent laparoscopic appendectomy for appendicitis. No other conditions were reported in her previous history except hypertension and type 2 diabetes. The colon scope shows that the appendicial office was swollen with nodular protrusion on the mucosal surface and slight congestion. The patient was diagnosed with Stomach Appendicitis. After a comprehensive evaluation and informed consent, Transconic Endoscopic Appendectomy was performed. The patient was under general anesthesia with endotracheal intubation and in a right lateral position. A transparent cap was attached to the tip of the endoscope. Before the procedures, cecum and ascending colon were washed repeatedly to clean the operative region. Here is the video of the procedures. We can see the swollen orifice. First step, submucosal injection with normal saline and indigo carmine was made around the orifice. Then a mucosal insertion was performed on the wrist mucosa with a hook knife also around the orifice. Here we can see a bleeding. In order to better display the bleeding points, we have switched to the RDI mode. A hot biopsy forceps was used to stop bleeding. We can see that the hemorrhage was stopped quickly. Then we continue to make a four-thickness incision with hook knife. As we can see here, the four-thickness incision was achieved. We replaced with IT knife to cut along the circumference of the orifice by endoscopic four-thickness resection technique. We extended the blade towards the abdominal cavity. The ceramic tip can protect the abdominal tissue from damage. So IT knives are very suitable for full thickness resection. We continued cutting along the appendicial orifice. Here we can see that the full thickness insertion of the circumference has been completed. We can see adhesion between appendicial stump and the surrounding tissues. The dissection along the gap was gradually performed with IT knife. Here we can see the dissection of appendicial stump has been accomplished. Then we used a sneer to take it out from the ball lumen. After careful hemostasis, the sickle defect was closed by pure string suture with the end loop and metal clips. First we placed an end loop at the tip of the endoscope and released it into the intestinal cavity. Then we used several clips to fix the end loop around the defect. In this way we don't need to replace a two-channel endoscope. We used a grasping forcep to help stand all the clips up, then tighten the end loop. We cut off the long tail of the end loop. To ensure that the defect was closed perfectly, an extra end loop was used. The puncture syringe was kept in place until the defect closure had been completed. The reduction of bubbles indicated a perfect closure. Stomper pendicitis is a real and late complication following a pendidectomy. It is a possible differential diagnosis in patients with pain in the right iliac fossa previously undergone a pendidectomy. Completion of a pendidectomy is the treatment of choice for stomper pendicitis. Here we present a normal minimally invasive technique which will probably replace secondary abdominal surgery for patients. In concluding, transconical endoscopic pendidectomy is a novel natural orifice transluminal endoscopic surgery technique inspired by endoscopic foresickness resection. It is feasible and safe for minimally invasive treatment for stomper pendicitis. Thank you for listening.

Transconic Endoscopic Appendectomy

stomach appendicitis

minimally invasive surgery

appendix removal

post-appendectomy complication