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appendicectomy

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Appendicitis

Alternative Names 
laparoscopic appendicectomy

Definition
An appendicectomy is surgery to remove the appendix, a small, finger-shaped pouch found at the junction of the small and large intestines.

Who is a candidate for the procedure? 
Usually, appendicectomies are done on people who have an infected or ruptured appendix. Because humans no longer need the appendix and infection is so dangerous, a healthy appendix is sometimes removed during another operation. This is done only when it will not add risks to the main surgery or call for another incision.

Many conditions, such as pelvic infections, renal colic, gastroenteritis (inflammation or infection of the stomach or intestines) and ovarian problems, cause symptoms similar to appendicitis. Exploratory surgery must be done to confirm appendicitis. Sometimes, even when a surgeon cannot be sure there is a problem, he or she will take out the appendix to be safe.

How is the procedure performed? 
The surgery can be done in two ways:
  • In an open appendicectomy a cut is made through the wall of the lower belly on the right side.
  • In a laparoscopic appendicectomy three small cuts are made in the belly button and abdomen. A harmless gas is pumped into the abdomen to separate the organs. A scope that lets the surgeon see inside the body and tiny surgical tools are passed through the incisions. If the appendix is ruptured, the surgeon may have to go to open surgery.
Usually, just an artery and a veil of thin tissue links the appendix to the intestines. Once the surgeon opens up the body, it is a fairly simple job to clamp off tissues and the artery so that the organ can be safely removed.

What happens right after the procedure? 
If the appendix was not ruptured, a person:
  • may eat within 24 hours and often go home within 24 to 48 hours.
  • should limit activities and take analgesics for several days.
  • may be given antibiotics.
What happens later at home? 
Once home, a person should:
  • try to limit lifting as much as possible until given other advice.
  • eat a soft, bland diet for a few days.
  • take any medication recommended.
  • use a mild laxative such as or stool softener, such as coloxyl sodium (docusate sodium), if no bowel movement occurs by 72 hours after leaving the hospital. Eating prunes or drinking prune juice may help, too.
  • use a heating pad sparingly to relieve pain around the incision site(s). Usually, this is just a muscle ache.
  • stay active by going on short walks. Slowly resume daily activities.
What are the potential complications after the procedure? 
Infection is the biggest problem after this type of surgery. As many as one in five people who have a ruptured appendix may develop an abscess (collection of pus) in the abdomen that needs to be drained. This may not show up for as long as 2 weeks after surgery. Some people get an infection around the site through which an infected appendix was removed. Because of this, a surgeon may leave the wound partially open to heal on its own.

Author: Michael Peetz, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 15/02/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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