An appendectomy
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An appendectomy, or appendix removal, is the primary treatment for an appendix that is inflamed
or has burst. An inflamed appendix can lead to life
threatening complications, so an appendectomy is
often an emergency surgery.
What is an appendectomy?
An appendectomy is a surgery to remove the appendix. It’s the main treatment
for an inflamed appendix, commonly known as appendicitis.
The appendix is a small, tube-shaped pouch that’s attached to your intestines on the lower right side of your abdomen. Its exact purpose is unknown. Your body can still function without it.
It’s important to seek treatment right away if you’re having symptoms of appendicitis
, such as:
abdominal pain that spreads to the lower right side
abdominal swelling
constipation
or diarrhea
nausea
vomiting
loss of appetite
fever
If you don’t receive treatment for appendicitis, your appendix can rupture (burst).
A ruptured appendix
can release bacteria
and other toxins into your abdominal cavity. This can lead to a longer hospital stay and could be life threatening.
Why is an appendectomy performed?
An appendectomy is performed to treat appendicitis. This infection can occur when the opening of the appendix gets clogged with bacteria and stool. It causes your appendix to swell and become inflamed.
Without prompt treatment, your appendix could burst. If that occurs, bacteria from your appendix can spread into your bloodstream and cause sepsis
, a life threatening response to infection.
Other dangers of a ruptured appendix include:
peritonitis
, which is a type of abdominal inflammation usually caused by an infection
abscess, which is a collection of pus
Both are serious and require immediate treatment.
When to seek help
Appendicitis
is a medical emergency. If you have symptoms
, see a doctor or go to the emergency room immediately.
You’ll need treatment in order to prevent complications.
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Are there any appendectomy risks?
An appendectomy is a common and usually safe procedure.
However, there are some risks associated with the surgery, including:
internal bleeding
blood clots
infection
injury to organs such as the bladder or intestines
hernia
The risks associated with untreated appendicitis are much more severe than those associated with an appendectomy.
DID YOU KNOW?
Some children and adults with appendicitis
, including some whose appendix has ruptured
, won’t require surgery and will be able to treat their condition with antibiotics
alone.
How do you prepare for an appendectomy?
Once you’re at the hospital, a doctor will perform a physical exam and ask about your medical history.
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During the physical exam, the doctor will gently push against your abdomen to
locate the source of your abdominal pain.
When discussing your medical history, be prepared to tell the doctor about any
prescription or over-the-counter medications you’re currently taking. The doctor will tell you whether you need to stop taking any of them before your procedure.
Also, let the doctor know if you:
are pregnant or believe you may be pregnant
are allergic or sensitive to latex
or certain medications (such as anesthesia)
have a history of bleeding disorders
If the doctor catches your appendicitis early, they may also order blood and imaging tests. They may not perform these tests if you need an emergency appendectomy.
Timing of your surgery
If your appendix has already ruptured, you’ll likely have an emergency appendectomy that same day.
If your appendix hasn’t ruptured, your surgery may take place a few days after
you receive an appendicitis diagnosis. A delayed appendectomy is also known
as an interval appendectomy.
The World Society of Emergency Surgery
Trusted Source
updated its guidelines on acute appendicitis in 2020. According to the guidelines for adults, if your appendix hasn’t ruptured, delaying surgery by up to 24 hours won’t increase your risk of complications such as rupture.
Regardless of whether you have an emergency or interval appendectomy, you’ll need to stop eating and drinking (water included) for a few hours beforehand.
According to 2017 guidelines from the American Society of Anesthesiologists, you should avoid heavier meals for at least 8 hours
before an elective procedure that requires anesthesia. This includes fried foods, fatty foods, and meat. Having a light meal up to 6 hours before your procedure is safe. You can also have clear liquids (except for alcohol) for up to 2 hours beforehand.
How is an appendectomy performed?
Before your appendectomy, you’ll receive intravenous (IV) fluids and medications, including antibiotics
.
General anesthesia
is typically used during this procedure, which means you’ll
be asleep. Sometimes spinal anesthesia is used instead to numb you from the
waist down.
There are two types of appendectomy: open and laparoscopic.
The type of surgery you undergo will depend on several factors, including the severity of your appendicitis and your medical history.
Surgery typically lasts around 1 hour
.
Open appendectomy
During an open appendectomy, a surgeon makes one incision in the lower right side of your abdomen. They remove the appendix and then close the wound with stitches.
This procedure allows the surgeon to clean the abdominal cavity if your appendix has burst.
A surgeon may choose to perform an open appendectomy if:
your appendix has ruptured, and the infection has spread to other organs
they don’t have experience in laparoscopic surgery
you have had abdominal surgery in the past
you have a lump called an appendix mass in the area where your appendix burst
Laparoscopic appendectomy
During a laparoscopic appendectomy
, a surgeon reaches your appendix through a few small incisions in your abdomen. They use a small, narrow tube
called a cannula to inflate your abdomen with carbon dioxide. The gas allows them to see your appendix more clearly.
After the surgeon has inflated your abdomen, they’ll insert a laparoscope through the incision. A laparoscope is a long, thin tube with a bright light and a
camera at the front.
The camera displays images on a screen, allowing the surgeon to see inside your abdomen. Your appendix is tied off with stitches and removed. The small incisions are then cleaned, closed, and dressed.
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Laparoscopic surgery typically has fewer risks and a shorter recovery time than open appendectomy. It may be the best option if you:
don’t have any complications from appendicitis
are at risk of surgery complications
have overweight or obesity
are older
are pregnant
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Can you have an appendectomy during pregnancy?
Appendectomy is safe during pregnancy. In fact, it’s safer for both you and your baby to have surgery right away than to let appendicitis go untreated.
Delaying surgery increases your risk of complications such as:
miscarriage
premature labor or delivery
infection
bleeding after delivery
The laparoscopic technique is preferred if you are pregnant and need to have an appendectomy.
What does an appendectomy for children involve?
Appendicitis is more common in people ages 10 to 19 years
than in any other age group. Appendectomy is the primary treatment for children and teens, just
as it is for adults.
Laparoscopic appendectomy is preferred for children with appendicitis
because it:
leads to fewer infections
causes less pain during recovery
requires a shorter recovery time than open appendectomy
Before this procedure, a child with appendicitis will receive IV fluids and antibiotics to treat any possible infection.
They’ll also receive general anesthesia. Your child will be asleep and won’t feel any pain during the surgery.
The risks associated with appendectomy in children include:
abscess
infection
bowel blockage
Your child should be able to return to their regular activities after recovering from an appendectomy. They can live a full, healthy life without an appendix.
What happens after an appendectomy?
Once your appendectomy is over, your healthcare team will observe you for a few hours.
They’ll closely monitor vital signs such as your respiratory and heart rates. They’ll also check for any reactions to the anesthesia or procedure.
How much time you spend in the hospital will depend on:
your overall health
whether your appendix bursts
whether you have open or laparoscopic surgery
how your body reacts to the surgery
If your appendicitis isn’t severe, you may be able to return home the same day
as your surgery.
If you receive general anesthesia, you’ll need someone to drive you home. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure.
The first few days of recovery
In the days following your appendectomy, you may feel moderate pain in the areas near the incisions. Any pain or discomfort should improve within a few days. The surgeon may prescribe medication to relieve the pain
.
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You’ll also need to avoid bathing or showering for a few days so that the incisions stay dry. You may have to adjust your diet, opting for only bland
or clear liquid
options.
Before you leave the hospital, your surgeon will provide specific instructions on do’s and don’ts.
Risk of infection
You might need to take antibiotics after surgery to prevent an infection. You can also reduce your risk for infection by keeping the incisions clean.
In the days after your surgery, watch for signs of infection, such as:
redness or discoloration around the incision
swelling around the incision
fever above 101°F (38.3°C)
chills
vomiting
loss of appetite
stomach cramps
constipation
or diarrhea
that lasts for more than 3 days
Recovery time
Although there’s a small risk of infection, most people recover from appendicitis and an appendectomy.
A full recovery from a laparoscopic appendectomy typically takes 1 to 2 weeks
. After an open procedure, it may take 4 to 6 weeks
to fully recover.
During this time, the surgeon will probably recommend that you limit physical activity so your body can heal. In addition, you’ll have a follow-up appointment
with them in the first few weeks after your appendectomy.
Appendectomy scar
Expect to see some scarring near the incisions. The scars from laparoscopic surgery are smaller than those from open surgery. Any scars should fade over time.
What’s the takeaway?
An appendectomy is the standard treatment for appendicitis.
An appendix that bursts can lead to serious complications, so it’s important to have this procedure quickly. Laparoscopic surgery causes less pain and results in a faster recovery time than open surgery, but it may not be right for everyone.
You may have relatively little time to prepare for your surgery. However, this procedure is safe for people across various age groups and during pregnancy.
A surgeon can let you know what to expect during and after surgery.
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Last medically reviewed on October 24, 2022
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Current Version
Oct 24, 2022
Written By
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Edited By
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Medically Reviewed By
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Medically reviewed by Shilpa Amin, M.D., CAQ, FAAFP — By Stephanie Watson — Updated on October 24, 2022
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Abdominal laparoscopy
Purpose
Risks
Preparation
Procedure
Recovery
Results
What is an abdominal laparoscopy?
A laparoscopy, also known as a diagnostic laparoscopy, is a surgical diagnostic procedure used to examine the organs inside the abdomen
, as well as other closed spaces, such as the knees. It’s a low risk, minimally invasive procedure that requires only small incisions.
When an abdominal laparoscopy is performed, a doctor uses an instrument called a laparoscope to look at the abdominal organs. A laparoscope is a long, thin tube with a high intensity light and a high resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor.
A laparoscopy allows your doctor to see inside your body in real time, without having to make large incisions. Your doctor can also obtain biopsy samples during this procedure, as well as also perform surgery.
Why is an abdominal laparoscopy performed?
A laparoscopy is often used to identify and diagnose the source of pelvic or abdominal
pain
. It’s usually performed when noninvasive methods are unable to help with diagnosis.
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In many cases, abdominal problems can also be diagnosed with imaging techniques such as:
ultrasound
, which uses high frequency sound waves to create images of the body
CT scan
, which is a series of special X-rays
that take cross-sectional images of the body
MRI scan
, which uses magnets and radio waves to produce images of the body
A laparoscopy is performed when these tests don’t provide enough information or insight for a diagnosis. The procedure may also be used to take a biopsy, or sample of tissue, from a particular organ in the abdomen.
Your doctor may recommend a laparoscopy to examine the following organs:
appendix
gallbladder
liver
pancreas
small intestine
and large intestine (colon)
spleen
stomach
pelvic
or reproductive organs
By observing these areas with a laparoscope, your doctor may detect:
an abdominal mass
or tumor
fluid in the abdominal cavity
liver disease
the effectiveness of certain treatments
the degree to which a particular cancer
has progressed
Your doctor may also be able to perform an intervention to treat your condition immediately after diagnosis.
What are the risks of an abdominal laparoscopy?
The most common risks associated with a laparoscopy are bleeding
, infection, and damage to organs in your abdomen. However, these are rare occurrences.
After your procedure, it’s important to watch for any symptoms of infection. Contact your doctor if you experience:
fevers
or chills
abdominal pain that becomes more intense over time
redness
or discoloration, swelling
, bleeding, or drainage at the incision sites
continuous nausea
or vomiting
persistent cough
shortness of breath
inability to urinate
lightheadedness
There is a small risk of damage to the organs being examined during a laparoscopy. Blood and other fluids may leak out into your body if an organ is punctured. In this case, you’ll need another surgery to repair the damage.
Less common risks include:
complications from general anesthesia
inflammation of the abdominal wall
a blood clot
, which could travel to your pelvis, legs, or lungs
In some circumstances, your surgeon may believe the risk of a diagnostic laparoscopy is too high to warrant the benefits of using a minimally invasive technique. This situation often occurs for people who’ve had prior abdominal surgeries, which increases the risk of forming adhesions between structures in the abdomen.
Performing laparoscopy in the presence of adhesions can take much longer and increases the risk of injuring organs.
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