Overview
Appendectomy is an emergency surgical procedure to remove an inflamed appendix before it ruptures and creates internal complications. Sudden pain on the lower right side of the abdomen can be a sign of appendicitis, which needs to be immediately addressed.
Alternate Name
Appendicectomy or appendix removal surgery
Body Location
Appendix attached to the large intestine and located in the lower right abdomen
Appendectomy Types
There are two types of appendectomy procedures commonly followed:
- Open appendectomy- It is the standard method of surgery to remove the appendix. It is more invasive in nature, as it involves appendix removal by making a large incision in the lower right abdomen.
- Laparoscopic appendectomy- It is a modern approach to removing the appendix, by using minimally invasive or keyhole surgery. Several small incisions are made, instead of a large one, due to which healing takes place faster.
How Appendectomy Surgery is Performed?
First, general or spinal anaesthesia is administered. Then, depending on the grade of appendicitis, one of the two procedures is performed.
Open Appendectomy
It is performed in the case of infection because of a ruptured appendix. A large incision is made in the lower abdomen to detach the appendix. The abdomen is then rinsed using saline water. The incision is closed with the help of stitches.
Laparoscopic Appendectomy
This is the most preferred method. Up to three tiny incisions are made near the navel. A laparoscope is inserted through one incision. Carbon dioxide gas is introduced via a port through another incision to create space in the abdomen. A tiny camera is also inserted so that the correct position can be located and the appendix removed. Fluids are drained out to avoid secondary infections. The incisions are then sealed using dissolvable stitches.
Preparation for Appendectomy Surgery
Getting ready for the surgery involves:
Signing the form
A consent form has to be signed by the patient to allow the procedure.
Pre-operative tests
A proper physical examination is done to check for any pre-existing conditions or allergies. Blood tests, imaging scans, and urine tests are advised accordingly.
Medications before the surgery
A sedative may be given pre-surgery. The patient is connected to an IV line through which necessary fluids can be administered.
Diet
Fruits, leafy vegetables, proteins, and whole grains may be consumed before the surgery. However, one should not eat or drink anything eight hours before the surgery.
When to get admitted
If not on an emergency basis, it is best to get admitted at least 24 hours before the scheduled time of the surgery.
Appendectomy Procedure Types
Open appendectomy
Invasive surgical procedure
Laparoscopic appendectomy
Minimally invasive (keyhole) surgical procedure
Follow Up
Once the vitals are stabilized after the surgery, the patient is observed for a day and then discharged. Antibiotics are prescribed to prevent secondary infections. A liquid diet is recommended for a couple of days after the surgery. After two days, solid food can be started, but it should be easy on the stomach.
Special care should be taken regarding the stitches. In the case of dissolvable stitches, they should be kept dry until they fall off. In the case of regular stitches, they are removed during the follow-up appointment.
Post-discharge, one should watch out for signs like redness, inflammation, or bleeding at the site of infection. If any warning signs are observed, they should be reported immediately. A follow-up visit must be scheduled with the healthcare provider after two to three weeks of the surgery.
Risks For Appendectomy Surgery
Possible side effects of the procedure include:
- Infection in and around the area of the incision
This results in bleeding or blood clot formation. It may also lead to pus-formation and inflammation.
- Bowel obstruction
This causes bloating, nausea, constipation, and severe belly cramps.
- Peritonitis related complications
If the appendix bursts during surgery (peritonitis), it may lead to abscess development. This can be treated with antibiotics and by draining the pus out.
- Damage to adjacent organs
If abdominal infection occurs, nearby organs like the small intestine and the bladder may be affected.
- Reactions because of medicines
The anaesthetics administered at the time of surgery may cause nausea, vomiting, muscle ache, or headache for a few days.
Recovery From Appendectomy Surgery
It takes around two to four weeks to recover post appendectomy. In the case of laparoscopic appendectomy, recovery is much smoother and faster. In the case of an open appendectomy or appendix bursting during the surgery, healing may get a bit complicated and delayed.
Sticking to the recommended diet and following the Appendicitis doctor’s instructions go a long way in making recovery easier. Resting well and drinking plenty of water helps avoid constipation issues. Moving around a bit ensures regular bowel movement and releases trapped gas. Heavy objects should not be lifted as doing so causes strain to the abdominal muscles.
One must not hurry and should gradually ease into their regular activities. The body must be given enough time and patience to rest and recuperate.
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