This is a normal appendix in a female patient found to have an infection of the reproductive organs. Since the appendix serves no useful function, it will be removed to save her from ever getting appendicitis in the future The first step is to free up the appendix down to where it is attached to the large bowel. This requires dividing the mesentery which contains the blood vessels that supply the appendix.
Bipolar forceps apply an electric current which seals the blood vessels and prevents bleeding.
Next, scissors are used to divide the mesentery. Now the base of the appendix is tied off using a pretied suture which is now being positioned. The suture has now been tightened and appears secure. The knot is a fisherman's knot, which can be tightened, but will not loosen on its own. As shown in this picture, the suture is now cut with the scissors.