Simultaneous Laparoscopic Cholecystectomy and Appendectomy

These are samples taken from the same patient during an operation. 

The most left is the removed Appendix. 

The middle is the removed Gallbladder. 

The most right is the soft gallstones removed from the gallbladder. 

This patient presented with one month history of right-sided abdominal pain in the middle. 

Typically, upper right-sided abdominal pain is caused by inflamed gallbladder(Acute Cholecystitis). 

Typically, lower right-sided abdominal pain is caused by inflamed appendix(Acute Appendicitis). 

So, the middle right abdominal pain give rise to the suspicion of simultaneously inflamed gallbladder and appendix(concomitant Acute Cholecystitis and Appendicitis). 

Since the gold standard operation to remove the gallbladder is by Laparoscopic Cholecystectomy, during the procedure, the appendix was also explored and confirmed to be inflamed. 

Laparoscopic Appendectomy was also attempted but due to adhesions and the retrocaecal location, dissection was hazardous and hence the procedure was converted to conventional Open Appendectomy.