Surgical instruments for appendectomy: open tray contents and layout

What the open tray must cover

An open appendectomy tray supports incision, access, handling of the appendix and its mesentery, ligation or clamping, and closure. It is essentially a compact general surgery set with a focus on abdominal wall work. Compare it with the wider general surgery instrument set and the larger laparotomy set.

Because the operation is often urgent, the tray should be standardised and ready, with a count sheet that can be checked quickly.

Local practice varies, so use the list below as a starting point and agree the final contents with the surgical team.

Core instrument groups

Cutting: a scalpel handle with blades, Mayo straight or curved scissors for tissue and sutures, and Metzenbaum scissors for fine dissection. Grasping: toothed tissue forceps for the abdominal wall, smooth or atraumatic forceps for bowel handling, and an atraumatic clamp for the appendix.

Clamping: several haemostatic forceps such as Kelly, Crile and Mosquito patterns for vessels and the mesentery, and sponge-holding forceps. Suturing: Mayo-Hegar needle holders. Retracting: hand-held retractors such as Langenbeck, Richardson or Deaver types. These are available across REDA's forceps, scissors and general surgery sections.

Choose lengths according to patient build and incision depth; many teams keep both a standard and a longer pair of scissors and forceps available on the back table.

• Scalpel handle, Mayo and Metzenbaum scissors
• Toothed and smooth forceps, atraumatic clamp
• Kelly, Crile and Mosquito haemostats
• Sponge-holding forceps and towel clamps
• Mayo-Hegar needle holder
• Langenbeck or similar hand-held retractors

How the tray is laid out

Instruments are laid out in the order they will be used: incision instruments first, then dissection and clamping, then retraction, then suturing. Keep similar instruments together and place the most-used items closest to the scrub nurse. Our guide on tray setup on a Mayo stand describes the logic.

Use a count sheet that matches the layout. A repeatable layout reduces the chance of a miscount and speeds preparation, which matters in emergencies.

Retraction and exposure

Open appendectomy typically uses hand-held retractors for a small incision, and a self-retaining system is added if the exposure is difficult. See hand-held retractors Langenbeck and Farabeuf and abdominal retractors for how they compare. Check that blades are the right size for the incision depth.

Having two sizes of hand-held retractors in the tray is a practical way to cope with different patient builds.

Laparoscopic needs and set maintenance

Laparoscopic appendectomy uses a separate set of ports, graspers, scissors and energy instruments, with reusable or disposable options. Our article on reusable modular laparoscopic instruments explains the principles. Keep the open tray available as a conversion back-up.

Inspect scissors, needle holders and ratchets after every cycle and plan for sharpening and repair. Beckfinity can quote REDA instruments for your appendectomy trays and help standardise the contents. Contact our specialists to request a quotation.

Document the tray contents in a controlled list so that any change, such as replacing one instrument pattern with another, is recorded and communicated to the whole team.