LA has a large peritoneal space with an open field of view and a clear view of both the pelvis and the subseptum, making it easy to handle irrigation. In diffuse peritonitis due to appendiceal perforation, thorough peritoneal flushing is a decisive factor in reducing abdominal infection. Those with thinner pus first do not use saline flush, and only suck the pus to prevent the spread of inflammation; those with thicker pus dilute with a small amount of saline in order to suck the pus; then use a large amount of saline, metronidazole, low molecular dextrose with repeated flushing and then suck out, and then deal with the appendix root according to the situation of gangrene and suppurative appendicitis combined with perforation, (1) more than 3 mm from the cecum wall, the appendix segment near the cecum wall is intact, and the inflammation of the cecum wall If the edema is not obvious, the entire appendiceal tract should be disconnected with the ultrasonic knife to prevent incomplete disconnection leading to vascular bleeding, and the active surface of the ultrasonic knife should be changed into a flat surface and slow cutting should be used to increase the microwave area; if the appendiceal tract edema is heavy, the tract should be clamped in situ when the ultrasonic knife is clamped on both sides to prevent the tract from being torn without microwave treatment leading to appendiceal vascular bleeding; if the appendix is posterior or heavily adhered to the lateral abdominal wall, it is necessary to If the adhesions are serious, the appendix itself is thicker, and the appendiceal segmental or root gangrene is not easily retracted, etc., intracavitary surgery is required, or the appendiceal tract should be cut off after clamping with a Chin clip; the appendiceal tract should be fully disconnected before ligature to close to the cecum wall, but do not damage the cecum wall; for this type of appendiceal root, the root proximal to the Endo a lop double ligature or direct laparoscopic silk knotting is used; ( 2) If the root gangrene perforation is close to the cecum wall, less than 3m away from the cecum wall, and the inflammatory edema of the cecum wall is obvious, after resection of the appendix and elimination of the root gangrene inactivated tissue, the inflammatory reaction of the cecum wall near the appendix root can be closed and fixed under the microscope if it is not serious; we use absorbent thread to perform “8” full-layer sutures, and the suture range If the inflammation and edema around the root perforation is heavy and cannot be sutured, a small part of the cecum wall is excised, a “8” full-layer suture is performed, and the nearby intestinal omentum is used to cover the ligature. (3) the whole appendix, including the root, was completely gangrenous, and it was impossible to distinguish and dissect the appendiceal root. All surgeries in this group were successful, and there was no intermediate open abdomen. In cases where the appendiceal stump needed to be sutured or the appendiceal root was completely gangrenous and could not be identified and treated, the appendiceal stump was evenly covered with medical bioprotein glue, and in this group, we applied ultrasonic knife, Endo a foop loop ligature, medical bioprotein glue, etc., and no postoperative intestinal leakage and celiac disease occurred. LA not only has the advantages of less patient trauma, less pain, less scar, faster recovery, less complications, etc. Moreover, it has the advantages of wide and clear view under laparoscopy, exact and complete flushing, not affected by the change of patient’s body shape and appendix position, and low infection rate of poke, etc. It reduces the serious complications such as abscess formation in the abdominal cavity due to the accumulation of pus in the abdominal cavity, especially the collection of pus in the upper abdomen and pelvis that cannot be removed. Gangrenous appendicitis, appendiceal perforation or peripheral abscess were once relative contraindications at the beginning of this operation, but with the accumulation of experience in laparoscopic surgery and the continuous improvement of equipment, they have now become indications for the operation. Gangrenous and purulent appendicitis combined with perforation and periappendiceal abscess such as poor appendiceal root conditions are more difficult to operate, and the operator must have rich experience in laparoscopic treatment, especially intra-abdominal suturing techniques, and strictly follow the operation rules and surgical principles to complete LA safely and effectively.