What is Appendectomy?
Appendectomy is a common emergency surgery which is performed to treat appendicitis. Appendicitis is an inflammatory condition of the appendix. An appendectomy is performed for surgical removal of the inflamed appendix.
The appendix sits at the junction of the small intestine and large intestine. It is situated in the right lower abdomen. Experts don’t completely understand what the appendix does, but most agree that it’s not important to a person’s health. Often, the appendix, becomes inflamed, infected, and can rupture. This causes severe pain, in the right lower part of the belly. It can also cause nausea or vomiting. Appendicitis is considered an emergency because it can be life-threatening if it’s not treated – the appendix occasionally bursts less than a day after symptoms start. So it’s very important to have it removed as soon as possible.
Types of Appendectomy
There are two types of appendectomies performed, which are:
- Open Appendectomy. In this type of procedure, a small incision (about 2 to 4 inches long) is made in the lower right side of your belly and the inflamed appendix is removed from here.
- Laparoscopic Appendectomy. A lesser invasive technique is laparoscopic appendectomy. So, instead to a long cut, 1 to 3 tiny cuts are made and the appendix is removed through one of these incisions.
However, during a laparoscopic surgery your surgeon may have to decide to perform an open appendectomy procedure. This happens in situations like if your appendix has burst and infection has spread. Laparoscopic appendectomy causes less scarring; however, in both the types of surgeries, the scar is hard to see once it is healed properly.
Both these type of appendectomy procedures have a very low risk of infections as well as developing complications. The recovery period for both the type of appendectomy surgeries is very short and both require a shorter hospital stay.
Risks of Appendectomy
Some possible risks of appendectomy include:
- Wound infection
- In case of a ruptured appendix during an appendectomy, about 20 percent of patients undergoing laparoscopic surgery face risks of growing abscesses.
- Injury to nearby organs.
- Blocked bowels
Preparing for the Appendectomy Surgery
- Ask any questions related to the appendectomy surgery to your healthcare provider.
- You will be asked to sign consent form before the appendectomy procedure. Read it carefully and ask any doubts you have.
- You must tell your healthcare provider about any kind of health issues you have or have had in the past. You may be ordered some blood tests or other diagnostic procedures.
- You must not eat or drink anything 8 hours prior to the appendectomy surgery.
- Do mention the names of medicines or supplements that you are taking currently.
- You should tell your healthcare provider about any sensitivity issues like allergy to latex, medicine, tapes, or anesthesia (local or general).
- Pregnant women should discuss all the risks involved for pregnant women.
- If you are on blood thinners or medicines that affect blood clotting, you may have to stop taking these medicines before the appendectomy surgery.
How is Appendectomy Done?
You are given medicines to put you into deep sleep (general anesthesia). Generally the following steps are performed during an appendectomy. You will be given a gown to wear and will be asked to remove your jewelries. An IV line will be put in your arm or hand. You will be placed on an operating table and taken to the operating room.
- A tube will be put down your throat to help you breathe during the procedure.
- During an open appendectomy procedure, the following steps are followed:
- A cut or incision will be made in the lower right part of your belly.
- Your abdominal muscles will be separated and the abdominal area will be opened.
- Your appendix will be tied off with stitches and removed.
- If your appendix has burst or ruptured, your abdomen will be washed out with salt water (saline).
- The lining of your abdomen and your abdominal muscles will be closed with stitches. A small tube may be put in the incision to drain out fluids.
During the laparoscopic appendectomy, the procedure is performed in the following order:
- A tiny incision will be made for the tube (laparoscope). More cuts may be made so that other tools can be used during surgery.
- Carbon dioxide gas will be used to swell up your abdomen so that your appendix and other organs can be easily seen.
- The laparoscope will be put in and your appendix will be found.
- Your appendix will be tied off with stitches and removed through an incision.
- When the surgery is done, the laparoscope and tools will be removed. The carbon dioxide will be let out through the cuts. A small tube may be placed in the cut to drain out fluids.
On completion of the appendectomy procedure, whether it’s an open or a closed procedure, your appendix will be sent to a lab to be tested. Stitches or surgical tapes will be put to your cuts. A sterile bandage or dressing will be placed to your wounds.
Recovery Period After Appendectomy Surgery
After the appendectomy surgery, the patient is taken to the postanesthesia care unit (PACU) until the anesthesia wears off. Here in the PACU, heart rate, temperature, and breathing are carefully monitored by the nursing staff. The patient is transferred to his/her hospital room as soon as the vital signs stabilize and anesthesia wears off. Recovery period of a patient depends on the severity of his condition and type of appendectomy surgery performed. Such as, an unruptured appendix patient has a faster recovery after the surgery. Feeds are gradually changed from clear liquids to semisolids and then solids. Once the patient is able to eat and drink properly. IV lines are removed. Most patients are allowed to do physical activities like moving out of the bed on the day of surgery or the next morning. Signs of infections are closely monitored at the incision site. Patients with uncomplicated appendectomy surgery usually leave the hospital in 1 or 2 days.
Recovery of a patient with ruptured appendix is comparatively slower. The hospital stay is about 4 days or more depending on the level of complications. A drain is left in place until the pus stops coming out. The antibiotics are given through IV line. After discharge the patient is given oral antibiotics and instructions are given for proper care of the area. Inform your healthcare provider if the drainage is increased or if its color or consistency changes.
- Appendicitis: Classification and Types, Epidemiology, Pathophysiology, Causes, Risk Factors, Symptoms, Signs, Treatment, Tests
- Acute Appendicitis: Causes, Signs, Symptoms, Treatment
- Ruptured Appendix: Causes, Symptoms, Treatment, Signs, Complications
- What Side is Appendix on & What Causes it to Burst?
- Signs That You Might Have Appendicitis