Table 3.

Examples of the steps within a surgical intervention: appendicectomy

Components	Definition	Description	Steps within each component
			Two further 0.5-cm incisions in the left iliac fossa and suprapubic regions.
		Separation and incision of the fat, fascia, muscular layers and peritoneum.	Identification of the base of the umbilicus.
			Incision of fascia using a knife and peritoneum using scissors.
		Creation of a pneumoperitoneum	Insertion of the laparoscopic ports (through fascia and peritoneum).
			Insufflation of gas into the abdomen.
Dissection of the appendix	The process of exposing an organ, tissue or structure	Dissection of tissues surrounding the appendix.	Use of a laparoscopic hook and diathermy to dissect the appendix from surrounding tissues.
		Isolation and ligation of the blood supply.	Use of hook diathermy to divide the mesoappendix and coagulate the artery.
Resection of the appendix	Removal of all or part of an organ, tissue, or structure	Securing the appendix base with staples/sutures.	Application of sutures to the base of the appendix.
		Division of the base of the appendix.	Cutting of the appendix from its base with laparoscopic scissors.
		Removal of the appendix from theabdomen.	Placement of a bag into the abdomen within which to retrieve the appendix through a laparoscopic port.
Closure of the abdomen	Closure of the abdominal layers	Closure of the peritoneum, fascia and skin.	Closure of the fascia at the umbilical port site using a box stitch. Closure of the skin at all three port sites, using sutures or steri-strips.