Diagnostics

Appendectomy

Understanding Appendix Removal Surgery

What is an appendectomy

An appendectomy is a surgical procedure to remove the appendix, the primary treatment for an inflamed appendix, commonly known as appendicitis.

When is appendectomy recommended by doctors?

The appendix is a small, tube-shaped pouch attached to the intestines on the lower right side of the abdomen. If an individual has symptoms of appendicitis, like abdominal pain on the lower right side, swelling, constipation or diarrhoea, nausea, vomiting, loss of appetite, or fever, it is essential to get immediate medical help.

If left untreated, appendicitis can lead to a ruptured appendix. A ruptured appendix can release bacteria and toxins into the abdominal cavity, resulting in a longer hospital stay and potentially life-threatening complications. Timely treatment is essential to avoid such risks.

Who conducts appendectomy?

An appendectomy is typically performed by a surgeon who specializes in general surgery. Appendectomies are commonly performed in hospitals and surgical centers equipped with operating rooms.

Types of appendectomy surgery?

There are two types of surgery to remove the appendix: open appendectomy and laparoscopic appendectomy.

  • Open appendectomy: In this standard method, a 2 to 4-inch long incision is made in the lower right-hand side of the belly or abdomen. The appendix is then removed through this incision.
  • Laparoscopic appendectomy: This newer, less invasive method involves making 1 to 3 tiny cuts instead of a large incision. A long, thin tube called a laparoscope with a tiny video camera and surgical tools is inserted through one of the incisions. The surgeon uses the camera and tools to view and perform the procedure, and the appendix is removed through one of the incisions. With laparoscopic appendectomy, patients typically experience less pain and a faster recovery period.


The type of appendectomy will depend on the medical condition and the surgeon’s decision-making.

How is appendectomy surgery performed?

Most cases are scheduled for an appendectomy after a diagnosis of acute appendicitis. Depending on the infection’s severity, antibiotic therapy may be prescribed for some days. Additional diagnostic tests, like blood tests and imaging scans, are conducted to assess appendicitis further. A complete medical history is taken, and the healthcare team explains the type of surgery they recommend, seeking the patient’s or family member’s consent. The patient will need to fast for 8 hours before the surgery, but fluids will be provided through the IV line.

During surgery

During the appendectomy, the patient is taken to the operating room, where general anesthesia is administered to induce deep sleep and a muscle relaxant to prevent muscle spasms.

The surgery’s specifics differ based on whether it’s a laparoscopic or open appendectomy.

For a laparoscopic appendectomy, a tiny incision is made near the belly button, and a cannula is inserted to inflate the abdominal cavity with carbon dioxide gas. This allows better visualization with a laparoscope. The surgeon uses this instrument to guide the removal of the appendix through small incisions.

A larger incision is made in the lower right abdomen for an open appendectomy. The surgeon accesses the appendix and may drain any fluids or abscesses if needed before removal.

After surgery

After the appendectomy, the recovery time varies. The patient may be discharged on the same day if it is a straightforward laparoscopic procedure. If complications arise or an open surgery is performed, hospitalization may extend for a few more days. The patient will continue to receive intravenous antibiotics as needed, and if applicable, a drainage tube may be used for peritonitis cases.

After an appendectomy, here are some do’s and don’ts to follow during the recovery at home:

Do’s:

  • Keep the incision(s) clean and dry to prevent infection.
  • Consume soft foods initially and gradually progress to more solid foods. Take it slow.
  • Limit physical activity, especially in case of open surgery, as the abdominal muscles may ache after prolonged standing.
  • Be vigilant and promptly contact the doctor if notice any unusual symptoms or concerns.


Don’ts:

  • Don’t take any medication the doctor has not approved, as some pain medications may increase the risk of bleeding.
  • Avoid bathing or swimming until stitches are removed or as directed by the doctor.
  • Refrain from straining abdominal muscles. Avoid activities such as stair climbing and lifting heavy objects.
  • Do not remain completely sedentary; getting up and walking around occasionally is essential to prevent blood clots and aid the digestive system.


An appendectomy, like any surgery, carries certain risks and potential complications, including:

  • Bleeding
  • Wound infection
  • Infection, redness, and swelling (inflammation) of the abdomen if the appendix bursts during surgery (peritonitis)
  • Blocked bowels
  • Injury to nearby organs


Appendectomy remains the safest and most effective treatment for appendicitis, preventing its recurrence and the risk of severe infection. Laparoscopy surgery, a minimally invasive approach, causes less pain and leads to a quicker recovery compared to open surgery, but it might not be suitable for everyone.

References

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