Appendectomy

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Definition | Body Parts Involved | Reasons for Procedure | Complications | What to Expect | Outcome | Call Doctor If

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Definition

Surgical removal of the appendix, which is a small tube-like projection that is attached to the large intestine

Parts of the Body Involved

• Appendix
• Abdomen
• Large intestine

Reasons for Procedure

An appendectomy is most often performed as an emergency surgery to treat appendicitis. Appendicitis is the inflammation of the appendix, which can result from an infection or if a piece of stool becomes trapped.

Risk Factors for Complications during the Procedure

One major risk factor is a delay in receiving treatment. The appendix can rupture within 24 hours after symptoms begin. If the appendix ruptures and its contents enter the abdomen, infection and inflammation occur, a condition called peritonitis. An infected sore, called an abscess, may also develop. If the appendix has ruptured and a mass can be felt, you may be given antibiotics to fight the infection, with surgery postponed until the inflammation subsides.

Other risk factors include:

• Age: 65 or older
• Obesity
• Diabetes
• Chronic lung or heart disease

What to Expect

Prior to Procedure

Your doctor will likely do the following:

• Physical exam
• Blood tests
• Urine analysis
• X-rays
• Ultrasound – a test that uses sound waves to find the appendix and other organs
• CT scan – a type of x-ray that uses a computer to make pictures of the inside of the body
• Antibiotics

In the days leading up to your procedure:

• If the surgery is planned, eat a light dinner the night before and do not eat or drink anything after midnight
• In an urgent situation, surgery will be done immediately, without regard to when you last ate

During Procedure - IV fluids, anesthesia, possibly a sedative

Anesthesia - General

Description of the Procedure - – The surgeon can remove your appendix using one of two methods: an open technique or a laparoscopic removal.

For the open technique, the surgeon makes a short incision in the lower abdomen. For a laparoscopic removal, the surgeon cuts a small opening near the navel and inserts a long, thin tubular instrument (laparoscope) that lights, magnifies, and projects an image of the internal organs onto a video screen. Two more small incisions made in the lower abdomen are used to insert tools to perform the removal. Carbon dioxide gas is pumped into your abdomen, to inflate it and make it easier for the surgeon to see the surrounding organs and operate.

With both methods, the surgeon detaches the appendix from surrounding tissue and stops any bleeding from blood vessels. The appendix is tied off and cut out. The surgeon positions the remaining stump and closes the incisions with stitches or tiny staples.

If the appendix ruptured, the doctor will use warm saline solution to clean the inside of the abdomen. A tube is then placed to drain any fluid that accumulates.

After Procedure - Laboratory examination of removed tissue

How Long Will It Take? 1-2 hours

Will It Hurt? Anesthesia prevents pain during surgery. You may be given pain medication to relieve pain and soreness during recovery.

Possible Complications:

• Infection, including peritonitis
• Intra-abdominal abscess
• Hemorrhage
• Anesthesia-related problems
• Bowel obstruction
• Injury to the bowel, ureter, or nearby organs

Average Hospital Stay: 0-3 days, depending on the type of surgery. Patients who have had laparoscopic surgery may go home the same day. If the appendix ruptured, expect to stay for several days or more than a week.

Postoperative Care:

• You may be given antibiotics to fight infection; take all the medications ordered, even if you start to feel better
• Drainage tubes placed if your appendix ruptured will be removed after a few days
• You'll get out of bed about six hours after surgery
• Rest and take it easy for 1-2 weeks
• Gradually increase activities as approved by your doctor
• Keep the incision area clean and dry
• Wash your hands before changing the dressing
• Do not exercise or do heavy lifting for one or more weeks, as directed by your doctor

Outcome

Recovery takes about four to six weeks. The appendix has no apparent purpose, so you can live without one.

NOTE: If the appendix ruptured, an increased risk of complications exists and recovery may take longer.

Call Your Doctor If Any of the Following Occurs

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
• Cough, shortness of breath, chest pain, or severe nausea or vomiting
• Increased abdominal pain
• Fainting
• Passing blood in the stool

SOURCE:

American College of Surgeons

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Last reviewed March 2001 by Medical Review Board