Appendicitis surgery, or appendectomy, is a surgical procedure done to remove an inflamed appendix. The two major types of appendicitis surgeries are laparotomy and laparoscopy. During laparotomy, a large incision is made on the middle or lower abdominal wall. In laparoscopy, a small incision is made and a camera is inserted through the incision to assist the surgeon in visualizing the appendix. Laparoscopic appendicitis surgery generally provides quicker recovery and leaves a smaller scar compared to laparotomic procedures, but is more expensive and time consuming.
Appendectomy is performed when the physician gives a diagnosis of appendicitis. The appendix is a small pouch attached to the colon and is located in the lower right side of the abdomen. When the lumen of the appendix becomes obstructed with impacted feces, parasites, enlarged lymph nodes, or trauma, the normal bacterial flora inside this pouch multiply and induce inflammation.
If left on its own, the inflamed appendix enlarges and becomes prone to bursting or rupture. The rupture of the inflamed appendix is dangerous because it can cause peritonitis, a generalized inflammation of the walls of the abdominal cavity, and sepsis, an infection of the bloodstream. Physicians generally recommend an appendectomy once acute appendicitis has been diagnosed.
Abdominal pain, usually starting in the stomach, traveling to the lower right abdomen, and then encompassing the entire area, is one of the most common symptoms of appendicitis. Fever is usually present, and accompanying symptoms often include nausea, vomiting, loss of appetite, and constipation. Some people experience chills and rectal tenderness. When these symptoms are present, a doctor should be consulted immediately to avoid rupture. Appendicitis is considered a medical emergency, and treatment is needed as soon as possible.
Laparoscopic appendicitis surgery begins with making three to four small cuts in strategic locations in the abdomen. A tiny camera and several surgical instruments are then inserted into these cuts, and a real-time video of the abdominal cavity and the inflamed appendix is projected onto a television monitor. This video helps surgeons remove the inflamed appendix without harming the other abdominal contents. The advantages of laparoscopic appendicitis surgery include minimal postoperative pain, faster recovery and return to usual activities, shorter duration of hospitalization, less complications, and smaller scars.
In open appendectomy, general anesthesia is given and intravenous antibiotics are provided a few hours before surgery. Various muscles and fascia of the abdominal wall are cut. The location of the cut depends on the orientation of the appendix and the severity of the patient’s condition. After the surgery, the patient is brought to the recovery room, where recovery is expected within 2 to 5 days.
