Appendectomy

Appendectomy

(Appendix Removal, Laparoscopic Appendectomy, Open Appendectomy)

Procedure overview

What is an appendectomy?

An appendectomy is the surgical removal of the appendix, a tube about six inches long or less that branches off the large intestine. The procedure is performed to treat appendicitis, an inflammation of the appendix caused by infection.

Acute appendicitis is the most common condition of the abdomen to require emergency surgery. Because of the likelihood of the appendix rupturing and causing a severe, life-threatening infection, the usual recommendation is that the appendix be removed as soon as possible.

What causes appendicitis?

Anatomy of the digestive system
Click Image to Enlarge

Appendicitis occurs when the interior of the appendix becomes filled with something that causes it to swell, such as mucus, bacteria, foreign body, stool, or parasites. The appendix then becomes irritated and inflamed. Rupture (or perforation) occurs as holes develop in the walls of the appendix, allowing stool, mucus, and other substances to leak through and get inside the abdomen. An infection inside the abdomen known as peritonitis occurs when the appendix perforates.

Because of the risk of rupture, which may occur as soon as 48 to 72 hours after symptoms begin, appendicitis is considered an emergency and anyone with symptoms needs to see a doctor immediately.

What are the symptoms of appendicitis?

Appendicitis may cause pain in the abdomen which may be described as follows:

Other symptoms of appendicitis include, but are not limited to, nausea and vomiting, loss of appetite, fever and chills, constipation, diarrhea, inability to pass gas, and abdominal swelling.

The symptoms of appendicitis may resemble other medical conditions or problems. In addition, each individual may experience symptoms differently. Always consult your doctor for a diagnosis.

It is important that people with symptoms of appendicitis not take laxatives or enemas to relieve constipation, as these medications and procedures can cause the appendix to burst. In addition, pain medication should be avoided, as this can mask other symptoms.

Types of appendectomies

The appendix may be removed in one of two ways:

During a laparoscopic appendectomy, your doctor may decide that an open appendectomy is needed.

A laparoscopic appendectomy may cause less pain and scarring than an open appendectomy, although even for open appendectomy, the scar is often hard to see once it has healed.

Open and laparoscopic techniques are thought to be comparable in terms of low rates of complications. However, length of hospital stay, length of overall recovery, and infection rates are reportedly lower with laparoscopic appendectomy.

Reasons for the procedure

An appendectomy is performed to remove the appendix when appendicitis is strongly suspected. During other abdominal surgical procedures, the appendix may be removed as a precaution to prevent future inflammation or infection of the appendix.

There may be other reasons for your doctor to recommend an appendectomy.

Risks of the procedure

As with any surgical procedure, complications may occur. Some possible complications include, but are not limited to, the following:

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Before the procedure

During the procedure

Illustration of laparoscopic appendectomy
Click Image to Enlarge

In general, an appendectomy is performed as emergency surgery and may require a hospital stay. Procedures may vary depending on your condition and your doctor's practices.

An appendectomy is generally performed while you are asleep under general anesthesia.

Generally, the appendectomy follows this process:

Laparoscopic method appendectomy:

After the procedure

In the hospital

After the procedure, you will be taken to the recovery room for observation. Your recovery process will vary depending on the type of procedure performed and the type of anesthesia that is given. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room. As a laparoscopic appendectomy procedure may be performed on an outpatient basis, you may be discharged home from the recovery room.

You may receive pain medication as needed, either by a nurse or by administering it yourself through a device connected to your intravenous line.

You may have a thin plastic tube inserted through your nose into your stomach to remove gastric secretions and air that you swallow. The tube will be removed when your bowels resume normal function. You will not be able to eat or drink until the tube is removed.

You will be encouraged to get out of bed within a few hours after a laparoscopic procedure or by the next day after an open procedure.

Depending on your situation, you may be given liquids to drink a few hours after surgery. Your diet may be gradually advanced to more solid foods as tolerated.

Arrangements will be made for a follow-up visit with your doctor, usually two to three weeks after the procedure.

At home

Once you are home, it is important to keep the incision clean and dry. Your doctor will give you specific bathing instructions. If stitches or surgical staples are used, they will be removed during a follow-up office visit. If adhesive strips are used, they should be kept dry and generally will fall off within a few days.

The incision and the abdominal muscles may ache, especially after long periods of standing. Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.

Walking and limited movement are generally encouraged, but strenuous activity should be avoided. Your doctor will instruct you about when you can return to work and resume normal activities.

Notify your doctor to report any of the following:

Following an appendectomy, your doctor may give you additional or alternate instructions, depending on your particular situation.

Online resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your health care provider with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American College of Gastroenterology

American Gastroenterological Association

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

National Institutes of Health (NIH)

National Library of Medicine

Society of American Gastrointestinal and Endoscopic Surgeons

 

Top of Page return to top of page