Removal of the Appendix

DEFINITION

The appendix is a tubular structure located in the right lower abdomen that hangs from the large intestine. Although the appendix is not necessary for survival, it functions to fight infections in the body by producing immunoglobulins (bacteria destroying proteins). An infected appendix, called appendicitis, can burst and release stool and bacteria into the abdomen.

REASON FOR PROCEDURE

If left untreated, an inflamed appendix may rupture, causing peritonitis (intra-abdominal infection).

Symptoms

• Worsening abdominal pain that starts around the navel
• Fever
• Nausea and sometimes vomiting
• Loss of appetite

TREATMENT OPTIONS

Nonsurgical Option

If you only have mild signs of appendicitis, observation may be necessary to determine if your symptoms get worse. If you have an abscess in the abdomen (a collection of pus signifying a perforation of the appendix), treating you with antibiotics for a few days to weeks may be the first step before elective surgery 4 to 6 weeks later. In some cases of abscess, a small drain may need to be inserted into the abscess under guidance by a radiologist to allow for the drainage of pus. Such a tube may remain in place for several weeks.

Surgical Option

Laparoscopic appendectomy or the conventional open removal of the appendix.

RISKS ASSOCIATED WITH SURGERY

• Bleeding
• Infection
• Removal of a normal appendix
• A leak at the edge of the colon where the appendix was removed
• Injury to adjacent organs such as the small intestine, ureter, or bladder.
• Blood clot to the lungs

(This is only a partial list of potential complications)

PRE-OPERATIVE PREPARATION

May include blood work, urinalysis, abdominal x-rays, and an abdominal CT scan.

AVERAGE HOSPITAL STAY

Varies amongst patients, but the average patient stays hospitalized for about 1 day. If the appendix has perforated, the hospitalization may last 4-6 days.

TYPE OF ANESTHESIA REQUIRED

Laparoscopic surgery requires general anesthesia which blocks pain and keeps you asleep throughout the entire procedure.

RECOVERY PERIOD

Once you have undergone laparoscopic surgery, your recovery period is usually shortened when compared to conventional open surgery. Most patients can usually go home within 1 to 2 days after the procedure although every case is different. You will be given pain medication along with a laxative to prevent constipation. Your activity may be limited to light lifting (no more than 20 lb) for one month.