Since the appendiceal mesentery runs from medial to lateral, it is safest to sweep a finger from the lateral parietal peritoneum under the appendix toward the medial side to explore and assess the situation. Fibrinous adhesions around the appendix can be freed in this fashion.
Sometimes the appendix can be mobilized and delivered by finger dissection alone. Care should be taken in the finger dissection not to hook the underlying ureter. The tip of the appendix is controlled by a Babcock clamp closed around the tip on the appendiceal mesentery.
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