View Table of Contents
- Appendicitis facts
- What is the appendix?
- What is appendicitis and what causes appendicitis?
- What are the complications of appendicitis?
- What are the symptoms of appendicitis?
- How is appendicitis diagnosed?
- How is appendicitis diagnosed? (Part 2)
- How is appendicitis diagnosed? (Part 3)
- Why can it be difficult to diagnose appendicitis?
- What other conditions can mimic appendicitis?
- What is stump appendicitis?
- How is appendicitis treated?
- How is an appendectomy done?
- What are the complications of appendectomy?
- Are there long-term consequences of appendectomy? What is new about appendicitis?
How is an appendectomy done?
During an appendectomy, an incision two to three inches in length is made through the skin and the layers of the abdominal wall over the area of the appendix. The surgeon enters the abdomen and looks for the appendix which usually is in the right lower abdomen. After examining thearea around the appendix to be certain that no additional problem is present, the appendix is removed. This is done by freeing the appendix from its mesenteric attachment to the abdomen and colon, cutting the appendix from the colon, and sewing over the hole in the colon. If an abscess is present, the pus can be drained with drains that pass from the abscess and out through the skin. The abdominal incision then is closed.
Newer techniques for removing the appendix involve the use of the laparoscope. The laparoscope is a thin telescope attached to a video camera that allows the surgeon to inspect the inside of the abdomen through a small puncture wound (instead of a larger incision). If appendicitis is found, the appendix can be removed with special instruments that can be passed into the abdomen, just like the laparoscope, through small puncture wounds. The benefits of the laparoscopic technique include less post-operative pain (since much of the post-surgery pain comes from incisions) and a speedier return to normal activities. An additional advantage of laparoscopy is that it allows the surgeon to look inside the abdomen to make a clear diagnosis in cases in which the diagnosis of appendicitis is in doubt. For example, laparoscopy is especially helpful in menstruating women in whom a rupture of an ovarian cyst may mimic appendicitis.
If the appendix is not ruptured (perforated) at the time of surgery, the patient generally is sent home from the hospital after surgery in one or twodays. Patients whose appendix has perforated are sicker than patients without perforation, and their hospital stay often is prolonged (four to seven days), particularly if peritonitis has occurred. Intravenous antibiotics are given in the hospital to fight infection and assist in resolving any abscess.
Occasionally, the surgeon may find a normal-appearing appendix and no other cause for the patient's problem. In this situation, the surgeon may remove theappendix. The reasoning in these cases is that it is better to remove a normal-appearing appendix than to miss and not treat appropriately an early ormild case of appendicitis.