Appendectomy

What is an appendectomy?

An appendectomy is the surgical removal of the appendix. The appendix is a three to six-inch long pouch-like structure in the lower right area of the abdomen. Appendicitis occurs when the appendix gets infected or inflamed. Appendicitis can cause abdominal pain and eventually a serious infection in the abdomen. An appendectomy cures appendicitis and eliminates its symptoms.

The function of the appendix is not entirely clear. It contains lymphoid tissue and it may assist the body in fighting infection. After an appendectomy, other organs take over the infection-fighting work of the appendix. You will have the same level of immunity as you did when you had an appendix.

An appendectomy is a major surgery with serious risks and potential complications. However, it can be a life-saving surgery. If your appendix has ruptured, you may require other treatments before surgery. This includes antibiotics and insertion of a drain through your abdomen to drain pus from an abscess around the burst appendix.

Why is an appendectomy performed?

The appendix extends out from the large intestine (the colon). Due to its location, the appendix can trap food, stool or ingested objects. This causes irritation, inflammation, rapid growth of bacteria, and infection—appendicitis. Removal of the appendix is the cure for appendicitis.

Without removal, an inflamed or infected appendix may rupture. This can result in a collection of pus (abscess) around the appendix. Infection can also spread throughout the abdomen. This is a life-threatening condition called peritonitis. Because of this, it is often necessary to have an appendectomy on an emergency basis without much warning.

How is an appendectomy performed?       

A surgeon will lead the surgical team and perform your appendectomy in a hospital. Your surgeon will make either a large incision or several smaller incisions in your abdomen. Your surgeon cuts out the appendix and ties off blood vessels. He or she will also clean out the abdomen if the appendix ruptures before removal. If the appendix has ruptured, the surgeon may leave a drain to collect fluid remaining in the abdomen. You will be taught how to care for the drain. It is usually removed before you leave the hospital.

Surgical approaches to appendectomy

Your doctor will perform an appendectomy using one of the following approaches:

• Minimally invasive surgery is a procedure performed by inserting special instruments and a laparoscope through small incisions in the abdomen. The laparoscope is a thin, lighted instrument with a small camera that transmits pictures of the inside of your body to a video screen. Your surgeon sees the inside of your abdomen on the screen as he or she performs the surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less  trauma to tissues and organs. Your surgeon will make a small incision instead of a larger one used in open surgery. He or she can then thread surgical tools around structures, such as muscle, instead of cutting through or displacing them as in open surgery.
• Open surgery is performed by making a large incision in the abdomen. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. This is because it causes more trauma to tissues. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.

In some cases, your surgeon may combine a minimally invasive procedure with an open surgery. In addition, your surgeon may decide after beginning a minimally invasive procedure that you require an open surgery to safely and most effectively complete your surgery. This may occur if you have severe bleeding or your surgeon finds a serious infection, abscess, or a ruptured appendix.