Port placement for laparoscopic appendectomy*

An open technique is used to enter the peritoneal cavity and place a 5 to 12 mm Hasson trocar at the umbilicus. The laparoscope is introduced through the umbilical port and two additional 5 mm ports are placed. The first is placed lateral to the left rectus muscle and medial to the anterior superior iliac spine. The second is placed in the suprapubic region at least 2 finger breadths superior to the pubic tubercle. Both the surgeon and the assistant stand on the patient's left side.
The surgeon operates using the two 5 mm ports (shown in red) and the assistant operates the laparoscope (shown in blue). One 12 mm port is needed to pass a surgical stapler to transect the appendix. The appendix is removed through the periumbilical port site, in a specimen bag.