What is Laparoscopic Appendix Removal Surgery (Laparoscopic appendectomy)?
What Is an Appendectomy surgery and appendicitis?
An appendectomy is the careful expulsion of the appendix. It’s an emergency surgery that’s performed to treat an inflammatory condition of the appendix i.e. appendicitis. The suffix “-itis” in the word appendicitis means inflammation, so the word appendicitis means inflammation of the appendix.
The appendix is a small, tube-shaped pouch attached to the large intestine which is located in the lower right side of the stomach. The exact purpose of the appendix is not known but it’s believed that it may help us recover from diarrhea, inflammation, and infections of the small and large intestines but the body can still function properly without an appendix.
At the point when appendix gets inflamed and swollen, the formation of pus can be encountered when the bacteria multiplies inside the organ. This buildup of bacteria and pus can cause pain around the belly button that spreads to the lower right section of the stomach. Walking or coughing can make the pain worse. Nausea, vomiting, and diarrhea can also be experienced
Treatment should be sought right away if having symptoms of appendicitis. When the condition goes untreated, the appendix can burst and release bacteria and other harmful substances into the abdominal cavity. This can be life-threatening, and will lead to a longer stay in hospital.
Appendectomy is the standard treatment for appendicitis. It’s critical to remove the appendix right away, before the appendix can burst. Most people recover quickly once an appendectomy is performed with no complications. Some patients, who are undergoing abdominal surgery for some other reason, may have their appendix removed prophylactic-ally so that appendicitis does not develop in the future; this option can be discussed with your surgeon.
Appendectomy for Children
What is an appendectomy for children?
An appendectomy is a surgery to remove a child’s appendix. The appendix is a small pouch that’s attached to the large intestine. It is on the lower right side of the abdomen.
An appendectomy may be done as an open surgery. This involves cutting into the belly and removing the appendix. Or it may be done through one or several smaller cuts using a camera and small instruments. This is called a laparoscopic surgery.
Why might my child need an appendectomy?
Doctors still don’t fully understand what the appendix does. But it doesn’t seem to be a vital organ. What is known is that it makes proteins called immunoglobulins. These help fight infection in the body.
Sometimes the appendix becomes blocked. Mucus trapped inside can allow bacteria to grow. That can lead to infection and inflammation (appendicitis). This illness is very common in children, teens, and young adults. A young person with this problem may need an appendectomy.
An appendix that is inflamed can burst if it is not taken out. If that happens, infection can spread throughout the belly (abdomen). It can cause a potentially dangerous health problem called peritonitis.
What are the reasons for an Appendectomy surgery to be performed?
An appendectomy is often done to remove the appendix when an inflammation and swelling occurs due to infection. This condition is known as appendicitis. The infection may occur when the opening of the appendix becomes clogged with bacteria and stool. This causes your appendix to become swollen and inflamed.
The easiest and quickest way to treat appendicitis is to remove the appendix. The appendix could burst if appendicitis isn’t treated immediately and effectively. If the appendix bursts, the bacteria and fecal particles within the organ can spread into your stomach which may lead to a serious infection called peritonitis. An abscess could be developed if the appendix bursts. Both are life-threatening situations that require immediate surgery.
Symptoms of appendicitis include:
- stomach pain starting suddenly near the belly button and spreads to the lower right side of the abdomen
- abdominal swelling
- rigid abdominal muscles
- constipation or diarrhea
- appetite loss
- low fever
Although pain typically occurs in the lower right side of the abdomen from the appendicitis, pregnant women may have pain in the upper right side of the abdomen as the appendix is higher during pregnancy.
Go to the emergency room immediately if you believe you have appendicitis. An appendectomy needs to be performed right away to prevent complications.
What Are the Risks associated with an Appendectomy?
Appendectomy being a fairly simple and common procedure there are some risks associated with the surgery, including:
- injury to nearby organs
- blocked bowels
It’s important to note that the risks of an appendectomy are much less severe than the risks associated with untreated appendicitis. An appendectomy needs to be done immediately with the untreated appendicitis to prevent abscesses and peritonitis from developing.
Sometimes the inflammation associated with appendicitis interferes with the action of the intestinal muscle and prevents bowel contents from moving. Symptoms which may occur are Nausea, vomiting, and abdominal distention when liquid and gas build up in the part of the intestine above the blockage. In these cases, a tube is inserted into the nose and advanced down the esophagus into the stomach and intestines — may be necessary to drain the contents that cannot pass. The tube inserted is known as nasogastric tube
To help diagnose appendicitis, your doctor will likely take a history of your signs and symptoms and examine your abdomen.
Tests and procedures used to diagnose appendicitis include:
- Physical exam to assess your pain. Your doctor may apply gentle pressure on the painful area. When the pressure is suddenly released, appendicitis pain will often feel worse, signaling that the adjacent peritoneum is inflamed.
Your doctor may also look for abdominal rigidity and a tendency for you to stiffen your abdominal muscles in response to pressure over the inflamed appendix (guarding).
Your doctor may use a lubricated, gloved finger to examine your lower rectum (digital rectal exam). Women of childbearing age may be given a pelvic exam to check for possible gynecological problems that could be causing the pain.
- Blood test. This allows your doctor to check for a high white blood cell count, which may indicate an infection.
- Urine test. Your doctor may want you to have a urinalysis to make sure that a urinary tract infection or a kidney stone isn’t causing your pain.
- Imaging tests. Your doctor may also recommend an abdominal X-ray, an abdominal ultrasound, computerized tomography (CT) scan or magnetic resonance imaging (MRI) to help confirm appendicitis or find other causes for your pain.
Appendicitis treatment usually involves surgery to remove the inflamed appendix. Before surgery you may be given a dose of antibiotics to treat infection.
Surgery to remove the appendix (appendectomy)
Appendectomy can be performed as open surgery using one abdominal incision about 2 to 4 inches (5 to 10 centimeters) long (laparotomy). Or the surgery can be done through a few small abdominal incisions (laparoscopic surgery). During a laparoscopic appendectomy, the surgeon inserts special surgical tools and a video camera into your abdomen to remove your appendix.
In general, laparoscopic surgery allows you to recover faster and heal with less pain and scarring. It may be better for older adults and people with obesity.
But laparoscopic surgery isn’t appropriate for everyone. If your appendix has ruptured and infection has spread beyond the appendix or you have an abscess, you may need an open appendectomy, which allows your surgeon to clean the abdominal cavity.
Expect to spend one or two days in the hospital after your appendectomy.
Draining an abscess before appendix surgery
If your appendix has burst and an abscess has formed around it, the abscess may be drained by placing a tube through your skin into the abscess. Appendectomy can be performed several weeks later after controlling the infection.
How to Prepare for an Appendectomy surgery?
To prepare for an appendectomy one will need to avoid eating and drinking for at least eight hours before the appendectomy. It’s also important to tell the doctor about any prescription or over-the-counter medications being taken. The doctor will tell how the medications should be used before and after the procedure.
One should also tell the doctor if they are:
- are pregnant or believe to be pregnant
- are allergic or sensitive to latex or certain medications, such as anesthesia
- history of bleeding disorders
After the procedure, an arrangement should be made for a family member or friend to drive home. An appendectomy is often performed using general anesthesia, which can make you drowsy and unable to drive for several hours after surgery.
Once at the hospital, the doctor will ask about the medical history and performing a physical examination. During the examination, the doctor will gently push against your abdomen to pinpoint the source of abdominal pain.
Blood tests and imaging tests may be suggested by the doctor if appendicitis is caught early. However, these tests may not be performed if your doctor believes an emergency appendectomy is necessary.
Before the appendectomy, patient will be hooked up to an IV so you can receive fluids and medication and likely to be put under general anesthesia, which means during the surgery the patient will be asleep. In some cases, local anesthesia will be given instead of general anesthesia. A local anesthetic numbs the area, so even though you’ll be awake during the surgery, you won’t feel any pain.
How Is an Appendectomy Performed?
There are two types of appendectomy: open and laparoscopic. The type of surgery the doctor chooses will depend on several factors, including the severity of your appendicitis and medical history.
During an open appendectomy, a surgeon makes one incision in the lower right side of your abdomen which allows the doctor to clean the abdominal cavity if appendix has burst. Appendix is removed and the wound is closed with stitches.
The doctor may choose an open appendectomy in case appendix has burst and the infection has spread to other organs. It’s also the preferred option for people who have had abdominal surgery in the past.
During a laparoscopic appendectomy, a surgeon the appendix is accessed through a few small incisions in your abdomen. A small, narrow tube called a cannula will then be inserted. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows the surgeon to see your appendix more clearly.
An instrument called a laparoscope will be inserted through the incision once the abdomen is inflated. The laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The camera will display the images on a screen, allowing the surgeon to look inside the abdomen and guide the instruments. When the appendix is found, it will be tied off with stitches and removed. The small incisions are then cleaned, closed, and dressed.
Laparoscopic surgery is usually the best option for older adults and people who are overweight. Laparoscopic surgery has fewer risks than an open appendectomy procedure, and also generally has a shorter recovery time.
What Happens After an Appendectomy?
When the appendectomy is over, the patient in under observation several hours before released from the hospital. The vital signs, such your breathing and heart rate, will be monitored closely. Hospital staff will also check for any adverse reactions to the anesthesia or the procedure.
The timing of release will depend on:
- the overall physical condition
- the type of appendectomy performed
- the body’s reaction to the surgery
In some cases, one may have to remain in the hospital overnight.
If the appendicitis isn’t severe, one may be able to go home the same day as the surgery. A family member or friend will need to drive home if general anesthesia is received. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure.
In the days following the appendectomy, moderate pain may be felt in the areas where incisions were made. Any pain or discomfort should improve within a couple of days. The doctor may prescribe medication for pain relief. They might also prescribe antibiotics to prevent an infection after surgery. To further reduce the risk for infection the incision need to be kept clean. One must also watch for signs of infection, which include:
- redness and swelling around the incision
- fever above 101°F
- loss of appetite
- stomach cramps
- diarrhea or constipation that lasts for more than two days
Although there’s a small risk of infection, most of the people recover from appendicitis and an appendectomy with little difficulty. Full recovery may take about four to six weeks from an appendectomy. During this time, doctor will probably recommend that one may limit physical activity so the body can heal. A follow-up appointment may need to be attended with the doctor within two to three weeks after the appendectomy.
The recovery time for an appendectomy depends on the type of the procedure, type of anesthesia, and any complications that may have developed during appendectomy. For example, the patient can be discharged to recover at home in case of laparoscopic appendectomy which could be done on an outpatient basis, while in an open method; it may require an overnight stay or an even longer time to be discharged to go home. Normal activities can be resumed in a few days but full recovery might take 4 to 6 weeks during which time strenuous activity should be avoided.
Possible complications and long-term risks associated with an appendectomy
A doctor can explain the risks associated with an appendectomy during pregnancy.
All surgical procedures carry some risks. Before performing the procedure, the surgeon should clearly explain the risks of an appendectomy with the individual.
The potential risks of an appendectomy may include:
- Intestinal obstruction: this postoperative complication is experienced by an estimated 3 percent of individuals, which prevents the passage of stool, gas, and fluid through the intestines. This blockage can result in severe complications without treatment.
- Premature labor: In about 8 to 10 percent of the cases, an appendectomy during pregnancy results in premature labor. The risk is usually higher if the appendix bursts. The rate of fetal loss resulting from this procedure is approximately 2 percent.
- Wound infection: Wound infection is a common complication. Wound infection complication affects 1.9 percent of people who have gone through laparoscopic surgery and 4.3 percent of those who undergo an open appendectomy.
Less than 1 percent of people undergoing an appendectomy experience the following complications:
- a blood clot
- heart complications, such as a heart attack
- urinary tract infection (UTI)
- Abscess formation in the area where the appendix has been removed or surgical incision site may also occur
For most of the individuals there are no long-term consequences of removing the appendix. However, there can be an increased risk of developing an incision hernia, stump appendicitis (infections due to a retained portion of the appendix), and bowel obstruction in some individuals.
Although the complications are rare to be experienced, but if anyone who has concerns about their symptoms should contact their doctor immediately.
A common surgical procedure to remove the appendix is known as appendectomy. An appendectomy is often performed by surgeons to treat appendicitis
The recovery time and the risk of complications depend on the severity of appendicitis and whether or not the appendix ruptured. Early recognition and diagnosis of appendicitis are vital in order to allow the person to get treatment before their appendix ruptures and the risk increases.
It may have some long term risks and complications as mentioned above. Many people can go home within 2 days of the procedure. It is not vital and necessary to make lifestyle changes after recovering from an appendectomy.
A person can live without the appendix as it does not perform any vital functions in the body.