Retrograde technique with intra‐corporeal tie in difficult laparoscopic appendectomy – a video vignette

Gangrenous, perforated or retrocaecal subserous appendicitis can be quite challenging due to the frailty of tissues and unclear surgical planes. In gangrenous appendicitis the usual meso-appendix dissection by traction on the appendix most probably leads to amputation. In retrocaecal subserous appendicitis, inflammation makes the planes extremely unclear with high risk of injuries to the caecal wall, right ureter or even the iliac vessels.