What is a laparoscopic appendectomy?
An appendectomy is the surgical removal of vermiform appendix, a finger-shaped sac attached to the beginning part of the colon (cecum). The appendix is located in the lower right abdomen.
A laparoscopic appendectomy is a minimally invasive surgical procedure to remove the appendix.
- The laparoscope is a flexible tube fitted with a video camera and light.
- Inserted through a tiny incision in the abdomen, the laparoscope enables the surgeon to visualize the appendix.
The surgeon performs the surgery with tiny surgical tools inserted through two tubes (cannulas) into two other tiny incisions.
Why is a laparoscopic appendectomy performed?
The appendix produces a protein that helps fight infection, however, its presence does not seem vital for an adult. Other parts of the body take over its function when it is removed.
A laparoscopic appendectomy is a common emergency surgery performed when the appendix is inflamed with infection (appendicitis) or ruptured. Appendicitis can result in symptoms such as
- acute abdominal pain
- loss of appetite
- nausea and vomiting
- constipation or diarrhea
- painful and/or frequent urination
Laparoscopic surgery has certain advantages over open surgery such as
- shorter hospital stay
- quicker healing
- less post-surgery pain
- less scarring
The surgeon may decide to convert a laparoscopic surgery into an open one in the following situations:
- Rupture of appendix
- Severe and extensive infection or abscess
- Inability to visualize appendix due to
- patient’s obesity
- scar tissue or adhesions from previous surgery
- Patients with
- bleeding disorders
- severe pulmonary diseases
- heart diseases
How is laparoscopic appendectomy performed?
A general surgeon performs a laparoscopic appendectomy under general anesthesia.
- Prior to a laparoscopic appendectomy, the patient
- Undergoes a physical examination, blood tests, and imaging tests.
- May be immediately administered medications for pain and nausea, and antibiotics for infection.
- Must avoid eating or drinking anything 8 hours prior to the surgery when possible.
- Must check with the surgeon before taking any regular medication.
- Must inform the surgeon of any medical conditions and allergies, or if pregnant.
An anesthesiologist administers anesthesia and monitors the patient’s vital functions during the surgery.
- A catheter may be attached to decompress the bladder.
- The patient is connected to an IV line.
- The patient may be intubated for oxygen supply.
- Makes three small incisions in the stomach wall.
- Inflates the abdomen with carbon dioxide through a cannula inserted in one of the incisions.
- Inserts the laparoscope through the second incision.
- Guided by the images from the laparoscope, finds, excises and removes the appendix using tiny surgical tools inserted into the incisions via the cannulas.
- Releases the gas in the abdomen through the incisions.
- Irrigates the area with saline and suctions the fluid.
- May attach a tube to drain fluids.
- Closes the incisions with stitches or staples.
The patient is brought out of anesthesia, taken to the recovery room, administered pain medication and monitored till vitals are stable.
The removed appendix is sent for testing.
What is recovery time for laparoscopic appendectomy?
- After a laparoscopic surgery the patient may be discharged the same day or the next day unless there is serious infection.
- The patient will generally be able to return normal activities within one to three weeks.
- The patient may have to follow diet restrictions for a few days and avoid strenuous activity.
What are the side effects of a laparoscopic appendectomy?
Appendectomy is one of the safest surgical procedures, though it does carry a few risks and complications.
Early complications include the following:
- Anesthetic side effects such as
- Bleeding and blood clots
- Surgical site infection
- Abdominal abscess
- Injury to nearby organs
- Formation of fistula (abnormal connection between unconnected parts of the bowel)
- Abdominal pain and/or swelling
- Peritonitis (inflammation of the stomach lining)
Late complications include:
- Bowel obstruction
- Gangrene in the bowel
- Hernia at the incision
- Stump appendicitis
- Recurrent infection in the remaining appendix stump
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