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Sample Digital Consent Form: Appendectomy

I, [Patient Name], hereby consent to undergo an appendectomy procedure to be performed by Dr. [Doctor Name] and their surgical team.

Procedure Overview

Appendectomy Surgical StepsStep 1: Anatomy and LocationAppendixLarge IntestineStep 2: Port PlacementCamera PortWorking PortWorking PortStep 3: Appendix RemovalAppendix Being RemovedSurgical ToolStep 4: ClosureSutures/Surgical GlueSmall Incisions ClosedNote: Actual incision sizes and locations may vary based on surgical approach and individual patient needs

Risks and Complications

  • Infection at the incision site
  • Bleeding
  • Injury to nearby organs
  • Reaction to anesthesia

Benefits

  • Relief from appendicitis symptoms
  • Prevention of appendix rupture and its complications

Alternatives

The alternative to this procedure is to not have surgery, which carries the risk of appendix rupture and severe infection.