Bloodless Appendicectomy: Pararectal approach

A transverse incision is made with the lateral end of the incision at the junction of the upper 2/3 and lower 1/3 of the line joining the umbilicus and anterior superior iliac spine. Dissecting down through skin and superficial fascia reveals the aponeuroses of rectus abdominis muscle medially and oblique and transversus abdominis muscles laterally. The aponeurotic sheets (between the muscles) are cut longitudinally down to and through peritoneum. As no muscles are cut or the fibres split, there is hardly any bleeding.