Submucosal tunneling cecetomy in a dog: is it applicable for appendectomy in human?

We hereby present the successful application of submucosal tunneling cecetomy on a 12-kg female Beagle dog to mimic appendectomy in human. The steps were as follows ([Fig. 1], [Video 1]). Step 1: mucosal incision – the colonic cavity was intensively washed with normal saline to avoid leakage of fecal contents; the mucosa opposite the ileocecal valve was chosen for mucosal incision; a 2-cm horizontal or oblique mucosal incision was created. Step 2: submucosal tunneling – a submucosal tunnel was created until intentional perforation of the muscularis propria, about 3 cm from the appendix; the distance of 3 cm provided critical working space and better visualization of the appendix. Step 3: dissection of the appendix – the appendix was then dissected from the mesoappendix with electrocoagulation of mesentery vessels. Step 4: ligation of the appendix – the bottom of the appendix was ligated with an endoloop. Step 5: resection of the appendix – the appendix was resected using a snare; to prevent leakage, the stump was then secured with another endoloop. Step 6: retrieval and mucosal closure – the appendix was retrieved by a snare; after careful hemostasis, the mucosal incision site was closed using hemostatic clips. The procedure took 50 minutes, and the dog was sacrificed after the operation.