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Appendectomy is a surgical procedure conducted to remove the appendix. This is done only in case where the appendix is infected and has chances of bursting in the abdomen. If this happens the bacteria and other waste products can gain entry into the abdomen leading to a serious problem.

What is the Appendix?

The appendix is a narrow, part of the intestine that looks like a finger. It is located at the lower right side of the abdomen. When the appendix gets infected it tends to cause a lot of pain and discomfort. In such a case, a surgery is conducted in an emergency to remove the appendix. If the surgery is not done, the appendix may burst and cause the infection to spread in the peritonitis, which is the abdomen.

What Causes Appendix?

The cause of the appendix is unknown. It can either occur due to a viral infection or bacterial infection. At times, the tube that connects the appendix to the intestine may get blocked. This blockage may be due to a trapped, small, hard stool fragment. This causes inflammation and infection in the appendix. At times, a rupture or blood clot may also lead to inflammation of the appendix.

Symptoms of Appendix

Appendix causes the following symptoms to appear:

  • Sharp pain in the abdomen near the navel that may worsen with cough or walking
  • Inability to eat
  • Low grade fever
  • Nausea
  • Vomiting in some cases
  • Constipation or diarrhea
  • Tenderness in the rectal area
  • Chills accompanied by shaking

Treatment Options for Appendix

The appendix is treated with surgery. This surgery is called as appendectomy. There are two types of appendectomy. One is called as laparoscopic appendectomy and the other includes open appendectomy. Before we look at the procedures, let us see some tips that will help you prepare for the surgery.

Before the Procedure

  • The doctor will explain the entire procedure to you beforehand.
  • You may be asked to sign a consent form.
  • A physical examination will be conducted and certain blood tests along with some diagnostic tests will be conducted.
  • One may have to fast and remain empty stomach before the procedure.
  • Those who are pregnant should notify this to the doctor immediately.
  • Let the doctor know about the medications you are currently taking and let him know of any drug allergy you may have.

During the Procedure

Appendectomy is performed under general anesthesia. You will be asked to:

  • Remove any jewelry or piercing before the procedure.
  • All clothing’s will have to be removed and a hospital gown will be given to wear.
  • The nurse will insert an intravenous (IV) line in your hand.
  • Any hair around the area of surgery will be shaved.
  • The heart rate, blood pressure, breathing and blood oxygen levels will be monitored continuously.

Open Method Appendectomy Procedure

In the open appendectomy, the surgeon will make an incision of about 2-4 inches long on the abdomen. The incision will be positioned on the lower right side of the abdomen. The surgeon will cut through the fat and muscle layers and reach the appendix. With the help of sutures, the appendix will be removed. In case of ruptured appendix, the abdomen will be washed with the help of saline. Any excess pus or fluid will be drained using a small tube. With the help of sutures or staples the abdominal cavity and muscles will be closed with stitches. The skin will be cleaned using an antiseptic solution. The site will be covered with steri-strips or bandage.

Laparoscopic Appendectomy

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In a laparoscopic appendectomy, 1-3 small incisions will be made in the abdomen. A small nozzle will be inserted into one of the incisions. The abdomen is then inflated with the helps of carbon dioxide. This allows a clear view of the abdomen during the surgery. From another incision a laparoscope is inserted that has a camera and light attached to the end. This helps the surgeon look inside the abdomen. In the third incision, the surgeon inserts his surgical instruments and removes the appendix. Saline is used to wash the abdomen. The carbon dioxide escapes through the incisions made and they are closed with the help of sutures or staples. The area is covered with steri-strips or bandage.

Recovery Period after Appendectomy

One may feel funny after coming out of anesthesia for a day or two. In this case, one should never attempt to drive, drink alcohol or take any important decisions, until fully recovered. One will be allowed to drink a small amount of water after 24 hours of the surgery. If the patient is not nauseous, he/she can resume eating regular food.

You will need help getting in and out of bed and while walking. One should avoid lifting any weight for at least 14 days after an open procedure and 5 days in case of laparoscopic procedures. One can get back to work in about 5 to 7 days or as suggested by the doctor. In case of children, gym and sports should be avoided for at least 2 to 4 weeks.

Avoid soaking in a bathtub till the bandages are removed. Take a light shower after a day or so under a doctor’s advice. If one observes light drainage on the site of incision, it is alright. However, if one observes yellow or thick discharge, and the site is red and inflamed, call the surgeon immediately.

Risks Related to Appendectomy

The risks of appendectomy are few, but may include the following complications:

  • Infection at the wound site
  • Inflammation of the abdomen due to rupture of appendix during surgery
  • Bowel obstruction
  • Bleeding from the site of incision
  • Pus formation
  • Side effects to medications given

The doctor may advise some pain relievers to curb the pain. One may receive additional instructions from the doctor depending on your condition. Appendectomy is a fairly common procedure and has very low chances of risk.

Written by: Saptakee sengupta
Date last updated: February 02, 2015