Appendectomy—Laparoscopic Surgery
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Definition
An appendectomy is the removal of the appendix. The appendix is a small, blind-ended tube that is attached to the large intestine.

Reasons for Procedure
An appendectomy is most often done as an emergency operation to treat appendicitis . Appendicitis is inflammation of the appendix. It can be caused by an infection or obstruction.

Inflamed Appendix

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Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Infection
  • Damage to other organs
  • Reaction to anesthesia
  • Blockage of the bowel
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect
Prior to Procedure
Your doctor may do the following:

  • Physical exam
  • Blood and urine tests
  • Imaging studies of the abdomen may be done to find the appendix and look for evidence of infection or inflammation, including:
Intravenous fluids and antibiotics will be started right away. Since appendicitis is an emergency condition, surgery is almost always done as soon a possible after the diagnosis is made.

Anesthesia
General anesthesia will be used. You will be asleep, with a temporary breathing tube in place.

Description of the Procedure
Three small incisions will be made in your abdomen. A laparoscope (small tool with a camera on the end) will be passed through an incision. Gas will be blown into your abdomen to make it easier for the doctor to see. Other tools will be inserted into the incisions. The camera will send images of your insides to a video screen. The doctor will use these images to find and remove the appendix.

The appendix will be detached from surrounding tissue. The doctor will stop any bleeding from blood vessels. The appendix will then be tied off and cut out. The incisions will be closed with stitches or staples.

After Procedure
The removed tissue is examined by a pathologist.

How Long Will It Take?
1-2 hours

How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay
You may go home on the same day, if the surgery was routine. If infection, rupture, or other complications happen the stay will be longer.

Post-procedure Care
At the Hospital
You will be asked to get out of bed about six hours after surgery.

Preventing Infection
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:

  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
At Home
Recovery takes about 1-2 weeks.

When you return home, do the following to help ensure a smooth recovery:

  • You may resume your normal preoperative diet as soon as possible.
  • You may be given antibiotics to fight infection. Take all the medicines your doctor gives you, even if you start to feel better.
  • Keep the incision area clean and dry.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Wash your hands before changing the dressing.
  • Rest, and take it easy for 1-2 weeks.
  • Do not exercise or do heavy lifting for one or more weeks as directed by your doctor.
  • Gradually increase activities as approved by your doctor.
Call Your Doctor
Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision sites
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Increased abdominal pain
  • Persistent nausea and/or vomiting
  • Lightheadedness or fainting
  • Passing blood in the stool
If you think you have an emergency, call for medical help right away.




RESOURCES:
American College of Surgeons

National Digestive Diseases Information Clearinghouse

CANADIAN RESOURCES:
Canadian Association of Gastroenterology

Canadian Family Physician

References:
American College of Surgeons website. Available at: http://www.facs.org. Accessed July 22, 2009.

Schwartz S. Principles of Surgery. 7th ed. New York, NY: McGraw Hill; 2001.

Townsend C, Beauchamp DR, eds. Sabiston Textbook of Surgery. 16th ed. Philadelphia, PA: WB Saunders; 2001.

Townsend C, Beauchamp DR, eds. Sabiston Textbook of Surgery. 17th ed. Philadelphia, PA: WB Saunders; 2003.

6/2/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Last Reviewed November 2012



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