What is an Appendectomy?
Appendectomies are surgeries that surgeons perform to remove the appendix. The procedure is considered the standard surgical treatment for the painful inflammation of the appendix or appendicitis. When inflamed, the appendix may rupture, and because of this, appendicitis is generally treated as a medical emergency. When the organ ruptures, the patient’s condition may become very serious, even though, when the organ’s healthy, it doesn’t seem to have a vital function.
In this article, Dr. Omar Rashid and his expert team talk about appendicitis, appendix removal surgery, and the key differences between laparoscopic appendectomy and open appendix removal surgery.
About The Appendix
This tiny, tubular pouch is located at the colon’s bottom, resembling a tiny tail no longer than a person’s pointer finger. Currently, the medical community isn’t sure about the appendix’s exact purpose.
Still, it can become swollen quickly, and inflammation may lead to the rupture of the tiny pouch. The burst of the appendix may spread infectious agents inside the abdominal cavity, potentially leading to peritonitis and even sepsis, which can be fatal. After becoming inflamed, the appendix may burst within only 36 hours, making quick medical assistance essential.
Appendix Removal Surgery: Why is it Performed?
For the most part, appendectomy is the safest way of treating an inflamed appendix. Still, in some cases, surgery might not be the right option. Some patients may be unfit for operation, while others may even get better with antibiotics.
Still, appendix removal surgery has been the go-to appendicitis treatment for over 120 years now, with around 300,000 interventions performed yearly in the US alone.
Appendectomy: Procedure Details
First of all, is appendix removal surgery a major procedure? While open appendectomies aren’t uncommon, laparoscopic appendectomies are more common. During open appendectomies, surgeons will make one larger incision to remove the pouch. In contrast, in the case of laparoscopic surgery, several small incisions are made, which heal faster and will cause less pain.
Surgery is typically performed under general anesthesia, and moderate pain is normal after surgery. Still, the discomfort should improve within a few days, and patients often get pain medication to make the recovery period even more bearable.
Before Appendectomy
The majority of appendectomies are scheduled within 24 hours of diagnosing acute appendicitis. To combat the infection promptly, your healthcare team will establish an IV line to administer antibiotics. The duration of antibiotic therapy varies, lasting from one to seven days, depending on the severity of the infection. Sometimes, your healthcare team may closely monitor your response to antibiotics before confirming the necessity of surgery.
Additional diagnostic assessments, such as blood tests and imaging scans, may be required to gain a better understanding of your appendicitis. A comprehensive medical history, encompassing existing medications, allergies, and medical conditions, will also be collected. Considering all these factors, your healthcare team will discuss the proposed surgical approach with you and seek your consent. Before the surgery, you must abstain from eating and drinking for at least 8 hours; however, you will continue receiving fluids through your IV line.
During Appendix Removal Surgery
During the procedure, patients will lie on their backs while being administered general anesthesia, which will put them in deep sleep. After that, they’ll have a thin tube inserted in their mouth and throat to monitor their breathing and ensure that their airways are clean.
During Laparoscopic appendectomy
In the case of a laparoscopic appendectomy, the surgical procedure commences with a small incision made in proximity to the belly button. A minuscule port is introduced through this incision, and within this port, a slender tube referred to as a cannula is inserted. The cannula serves the purpose of inflating the abdominal cavity with carbon dioxide gas, creating additional space for the operation and enhancing the visibility of the abdominal cavity and its contents in photographic images.
Following this step, the cannula is removed, and a laparoscope, which is a lengthy, slender tube equipped with a small light and a high-resolution camera, is inserted. The camera transmits the surgical procedure onto a video screen, enabling the surgeon to pinpoint the location of the appendix and guide the instruments through one to three minor incisions. On occasion, unforeseen complications may be revealed by the laparoscope, necessitating the conversion of the laparoscopic procedure to an open surgery to address them.
During open appendectomy
During an open appendectomy, your surgeon will create a single, larger incision in the lower right area of your abdomen. They will carefully access the abdominal cavity and gently separate the abdominal muscles to locate the appendix beneath. In cases where the appendix has ruptured, an abscess or fluid might be present within the abdominal cavity that requires drainage before the appendectomy can proceed. Subsequently, the abdominal cavity will be cleansed with a saline solution.
In both laparoscopic and open procedures, the appendix will be securely tied off using stitches, detached from the intestine, and then removed. Any surplus fluids and gas will be drained through the incisions. In instances of peritonitis, a drainage tube may be left in the abdomen to facilitate the ongoing removal of fluids, with the intention of removing it at a later time. Once the procedure is completed, the breathing tube will be removed, and the incisions will be meticulously closed using stitches, followed by cleaning and dressing. You will then be transferred to a recovery room, where you will regain consciousness.
After The Appendectomy
After laparoscopic surgery, patients may leave the hospital the same day. If the procedure was open surgery due to a ruptured appendix, the patient might need to stay in the hospital for a few more days while being on intravenous antibiotics.
Appendix Removal Surgery Side Effects
Some patients may experience the following side effects the following days:
- Constipation
- Abdominal bloating
- Nausea
- Gas pain
Appendectomy and Cancer Management
Typically, this procedure is not used to treat cancer of this nature. More commonly, patients undergo an appendectomy for appendicitis, and later, during pathology analysis, cancer is discovered. If the analysis reveals a small neuroendocrine tumor, less than 1 or 2 cm, the appendectomy might suffice to remove all cancerous tissue. However, if the neuroendocrine tumor is larger, displays aggressive features, or is not of neuroendocrine origin (such as adenocarcinoma or goblet cell carcinoma), a second operation to remove additional tissue is often necessary.
Non-Operative Appendicitis Management
Even though controversial, non-operative management of appendicitis involves treating the condition with antibiotics and avoiding surgery in selected cases. Patients are carefully diagnosed and selected based on specific criteria, including mild symptoms and absence of complications. Broad-spectrum antibiotics are administered to control the infection, and patients are closely monitored in a hospital or outpatient setting. Pain management and supportive care are provided to aid the healing process. Regular follow-up appointments are essential to assess the response to antibiotic therapy. However, there are potential risks, including the possibility of recurrence or complications, which might require surgery in the future. The decision to pursue non-operative management is made collaboratively between the patient and healthcare provider, considering factors such as the patient’s overall health and preferences. Consulting experienced healthcare professionals is crucial for making well-informed decisions.
Expert Help A Call Away
Undergoing abdominal surgery is never a preference, but in the case of appendicitis, prompt intervention is crucial. Appendectomy remains the most reliable and effective method for addressing appendicitis, preventing its recurrence, and averting the spread of infection, which can have severe consequences. Modern advancements, including laparoscopy, have introduced the option of minimally invasive outpatient appendectomy procedures when the situation permits. While we sincerely hope you never find yourself in need of this procedure, if circumstances necessitate it, take comfort in the knowledge that you will join the ranks of hundreds of thousands who undergo successful appendectomies each year.
That said, if you want to learn more about the procedure, feel free to reach out to us today.