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What is an Appendectomy?

An appendectomy (which is sometimes referred to appendicectomy ) is the surgical elimination of the organ known as the appendix. Appendectomy is mostly performed as an emergency surgical procedure when patients suffer from appendicitis.

How is Appendectomy Performed?

Appendectomy can be performed both as an open operation as well as laparoscopically. An appendectomy is most often performed laparoscopically, if the diagnosis is in doubt, or if the patients feel that they need to hide their telltale surgical scars near their umbilicus or in the pubic hairline.

However, although laparoscopic appendectomy has its cosmetic advantages, and its recovery time is a little quicker, this procedure is more expensive than conventional open surgery.

Conventional Open Appendectomy-

In the conventional open surgery, the surgeon makes an incision which is less than 3 inches in length in the lower right section of the abdomen. Once the infected appendix is identified, the surgeon separates the infected appendix from its surrounding tissues and removes it surgically from the cecum (an intraperitoneal pouch that forms the junction of the small and large intestine). After that, the cecum is closed and is returned back into the abdomen. In the end, the muscle layers and the skin are sewn together and the incision is closed.

Laparoscopic Appendectomy (LA)-

While performing appendectomy laparoscopically, which is also known as LA, four incisions of 1 inch in length are made in the abdomen. One incision is made near the umbilicus, while another one is made in an appropriate region between the umbilicus and the pubis. The other two incisions, which are even smaller in size, are made on the right side of the lower abdomen. The surgeon then passes the camera and special laparoscopy instruments through these openings and after identifying, frees the appendix from its surrounding tissues. Next, the appendix is removed from the cecum and the site of its former attachment is sewed. The infected appendix is removed from the body of the patient through any one of the two 1 inch incisions. In the end, the laparoscopic instruments are removed and the incisions are sutured and closed. During this whole procedure, the intraperitoneal space is filled with medical grade carbon dioxide gas, to inflate the abdomen, which is released after the surgery.

Recovery Time For Appendectomy-

The recovery time for appendectomy depends on and varies with the type of procedure and anesthesia used during the surgery. While laparoscopic appendectomy can be done on an outpatient basis so that the patients can recover back at home, an open surgical procedure will require an overnight or even longer hospital stay.

Normally patients after appendectomy can resume their normal daily activities within a few days. However, for the full recovery, it may take four to six weeks. Patients are advised to avoid strenuous activities during this period of time.

Risk and Long Term Consequences of Removing the Appendix-

While wound infections are the most common complications of this surgery, the formation of an abscess in the area of the surgical incision and also in the area close to the removed appendix has also been noticed as an aftermath of appendectomy.

Other rare complications may include lack of intestinal peristalsis (ileus), gangrene of the bowel, injuries to the internal organs and infections in the peritoneal cavity (peritonitis).

Major long-term consequences of appendectomy include increased risks of bowel obstruction, stump appendicitis (infection in the retained portion of the appendix still stuck with the cecum) and development of incisional hernia at the site of the scar.

A vermiform appendix is a small, blind-ended hollow tube. It is closed from an end and attached at the other side to the caecum, which is a pouch-shaped opening of the colon (large intestine), where the contents of the small intestine are emptied. An appendix is considered to be a vestigial organ in the human body, with no clear function or any useful purpose in humans. It is however suspected that previously in humans it served the purpose of cultivation of gut flora that could be beneficial in repopulating the intestines after being affecting by a gut flora attacking disease. It also supposedly functioned in the production of the endocrine cells during fetal life, whose function was regulation of hemostasis.

A possible function of exposing the white blood cells to antigens in the abdominal tract during the initial years of life that aided in the stimulation of the production of antibody and thus regulating the immune reactions in the gastro-intestinal tract is also speculated. An evolutionary disappearance of the appendix has been proved in humans. If an appendix is present in the body and undergoes any kind of blockage, it can lead to appendicitis which is a very painful and a potentially fatal inflammation.

The appendix is around 3-5 inches in length and 0.4-0.5 inches in width. Cavity of the appendix is narrow at the end where it joins the cecum. It constitutes of muscular walls that aid in expulsion of mucous secretions of the walls of appendix into the cecum. A blockage to the opening of appendix that prevents the expulsion of the mucus secretions of the cecum cause appendicitis. A fecalith, a solidified mass of the fecal matter is a common source of blockage of the appendix. Obstruction can also be a result of enlarged lymphoid follicles, worms in the intestine, trauma or tumors. The mucus secretions get collected in the appendix causing edema and the distension of the organ itself. With an increase in the distension of the organ, blood supply is affected. Discontinuation of the blood supply to the organ cause death due to necrosis of the appendiceal tissues.

Certain micro-organisms like the Yersinia species, Actinomyces, Mycobacteria species, Histoplasma species, viral agents like Cytomegalovirus, Adenovirus are implicated in the pathology of appendicitis. Microbial load on the necrosed organ further worsens the inflammation. Increased distension of the inflamed organ can cause it to burst and spill the contents into the abdominal cavity. The membranes that line the abdominal cavity and form the covering of the abdominal organs is known as the peritoneum. Spilling of the mucus contents from the appendix may affect the peritoneum too.

The presenting symptom of appendicitis is moderate to severe pain in the abdomen. With the progression of infection, pain becomes localized to the lower right part of abdomen called as the McBurney s point . Other common symptoms are abdominal tenderness, a progressive worsening of pain, pain during coughing or sneezing, nausea, vomiting, diarrhea, difficulty or inability to pass gas, fever, acute constipation, loss of appetite and sometimes even a urinary tract infection.

Appendicitis is diagnosed on the basis of a patient's history and physical examination by the physician. For a confirmatory diagnosis white blood cell count, a urine analysis, abdominal X-ray, barium enema, ultrasonography of the abdomen, computerized tomography scan, and laparoscopy can be advised.

In patients with a mild and confined appendicitis, antibiotics treatment is sufficient to resolve inflammation. The appendix may be removed later if required. The most common treatment of appendicitis is an appendectomy, where the inflamed appendix is removed before it bursts. Surgical removal of appendix remains the most sought after treatment option by the physicians.

In an open appendectomy, an incision of two to three inches in length is made on the skin and the passed the layers of abdominal wall over the location of the appendix. The appendix is freed from its mesenteric attachment to the colon and obliterating the opening on the colon with sutures. Pus is drained and the incision is closed.

Nowadays, to ensure minimum invasion, laparoscopic surgery also known as the key-hole surgery is done. It causes a minimal loss of blood, less scar tissue formation and quicker healing.

Even Roald Dahl faked having appendicitis in his famous book, but, what exactly is appendicitis? Wouldn t it be a little interesting, to say the least, to find out what causes it and what treatment a person can expect to undergo in the case of getting it?

Quite simply, appendicitis is the name of the condition when the appendix swells up. Under normal circumstances, it is about three and a half inches in length. The ironic part about this is the fact that though appendicitis may cause tremendous pain and warrants surgery, no doctor is really aware of the reason why the appendix exists, in the first place! As a matter of fact, it is fully possible to live without an appendix and many people have not experienced any health problems after having their appendix removed.

While the appendix does not serve any properly defined function, this really does not mean that appendicitis is something that is not all that serious. In fact, if there is an explosion of the appendix, a person can die without very strong levels of medication in a time bound manner!

So, what is the cause behind this scary prospect? Simply said, when the appendix gets blocked, the result is appendicitis. What blocks it? Well, it could be cancer, a foreign body or even stool! That being said, it is to be kept in mind that this is not the only reason as to why appendicitis exists. If there is an infection in the body, in response to it, the appendix may end up getting inflamed.

With the exception of a very small minority of cases in which very strong antibiotics are made use of in order to treat appendicitis, a surgery to remove the appendix is usually a given case scenario when a person has appendicitis. As a matter of fact, it is treated as an emergency and the doctors go ahead and start the treatment as soon as possible to avoid the possibility of the rupture of the appendix.

It usually takes about two or three weeks before a person can get back to normal activities though some gentle movement can be undertaken within about twelve hours since the end of the operation. There are two types of surgery. If a laparoscopic surgery is being performed, the recovery is relatively straightforward but if an open surgery is performed, the recovery can take more time and would require a greater amount of care.

Appendix is a vestigial organ situated at the junction of the small intestine and large intestine in the digestive system. A vestigial organ is the one that is there due to evolutionary changes but has no role to play.

Inflammation of the appendix causes Appendicitis which is a very painful condition and can be called a medical emergency which prompts that surgical removal of appendix is the only option. If left untreated, the appendix might burst and spill harmful material and infectious fluids into the abdominal cavity. This can have serious repercussions unless treated with very strong antibiotics. In order to avoid major complications, the doctor would prescribe an immediate surgery to treat Appendicitis. It should not be delayed. Generally, people aged between ten to thirty years report this condition.

Causes of Appendicitis:

Appendicitis is caused by a blockage of appendix by a foreign body (stone, bullet, pin, etc.), stool, pus, tumor, or cancer. It can also be caused by any infection in the body which can make the organ swell. Appendicitis may also result due to abdominal trauma or injury.

Types of Appendicitis:

There are generally two types of Appendicitis: Acute and Subacute Appendicitis:

Acute Appendicitis: This type of Appendicitis is marked by severe, intolerable abdominal pain which worsens very quickly, usually in a matter of few hours.

Subacute Appendicitis: This type of Appendicitis is characterized by recurrent but mild abdominal pain which starts and subsides on its own initially, so much so that the patient and the doctor do not realize the actual problem until it changes into Acute Appendicitis.

Symptoms of Appendicitis:

Some of the most common symptoms of Appendicitis are:

Sudden pain near the upper abdomen or navel may intensify. Pain may get worse on movement like while walking or coughing.

Vomiting and nausea.

Loss of appetite.

Continuous light fever.

Bloated abdomen.

Diarrhea or constipation with gastroenteritis.

Abdominal swelling and cramps.

Diagnosis:

Since the symptoms are very vague and are like those of other ailments of the bladder, intestinal infections, and gastroenteritis, it is often tricky to accurately diagnose Appendicitis at once. Following are the tests for diagnosing Appendicitis:

Abdominal examination to check inflammation.

Blood test to check if there is any infection.

Ultrasound to examine swelling in the appendix.

A CT scans.

Treatment:

Appendicitis is treated by surgically removing the appendix. This surgery is called Appendectomy. It can be performed as an open surgery in which a larger incision is required; or, by laparoscopy which involves very minor incision and hence heals very quickly without causing much pain or scars. But, in the case of a ruptured appendix, an open Appendectomy must be performed so that the abdominal cavity can be cleaned up too.

Post- Operative Care:

An open Appendectomy may take a month or longer to heal fully, but a laparoscopic procedure usually takes not more than three weeks at the maximum to heal completely. Following are some of the post-operative care:

Avoid strenuous physical activity to prevent stitches from getting undone. Also, do not stretch the body too much.

If the pain-killers do not help much, consult the doctor immediately.

Do not overwork. Have a sound sleep but stay active by attempting short walks.

Conclusion:

Appendicitis can escalate and progress very quickly causing life-threatening complications. It is therefore advisable to quickly go for Appendectomy as soon as it is established that this is the actual problem.

Appendicitis, also commonly referred to as epityphlitis, is generally an inflammation that is triggered by bacterial, fungal, or viral infections. Since the appendix happens to empty into the colon with lesser efficiency and because the lumen is also small, it experiences some form of obstruction, being otherwise vulnerable to infections. This then manifests in the form of a primary factor that causes appendicitis. The pain that generates from this affected region remains localized primarily within the right lower quadrant of your abdomen.

The inflamed appendix then gradually fills up with pus. Appendectomy is considered to be the only curative procedure to treat a case of appendicitis. Pre-operative care is always stressed upon immensely so as to provide the best results to the patients:

Complete bed-rest and relaxation is suggested to patients once the symptoms have been put under the light of clinical examination.
Intubation is then provided if necessary.
Patients also require to fast during the period right before the operation.
Antibiotics must be prescribed in order to prepare the patient for surgery.
Radiological and laboratory examinations are then carried out.
Blood sugar levels must be established to decide if the patient is ready to undergo surgery or not.
Patients who have any previous record of hypertension may be prone to experiencing some amount of anxiety right before the operation itself. If such a case arises, the surgery might be cancelled to avoid any incidence of complications.
Mental preparation must be taken by the patient himself since psychological and physiological stress has a way of jeopardizing the operation.
Presence of friends and family helps immensely to stabilize and relax the patients.
The patient must be explained the very nitty-gritty of the surgery and how it s going to take place so that he may not face anxiety.
A sedative might be introduced to the patient to help him relax.
Along with the aforementioned factors, a number of things need to be taken care of if the question of appendicitis arises. Since operations are primarily carried out as emergency surgeries, there is little that can be done at the last moment itself. Ensure that the person has an empty stomach and is stable enough to undergo the procedure.

Abdomen pain or abdominal pain is usually experienced in the area between the chest and the stomach. This kind of pain usually comes as a dull cramp that also produces shooting stabs of pains intermittently, or it may be a localised pain in one side of the stomach. This may also be accompanied by inflammation, and other diseases related to organs like intestines, kidneys, pancreas, liver, spleen and stomach.

So what are the causes of stomach or abdomen pain? Read on to find out:

1. Food Poisoning: Food poisoning can be caused due to dirty water or contaminated food. This can give rise to various infections as well as conditions like traveller's diarrhoea or loose motions.

2. Gastro Intestinal Conditions: GERD or gastroesophaegal reflux disease and gastroenteritis, among various others can also lead to abdomen pain as a symptom along with severe acidity and nausea. Irritable bowel syndrome is another major ailment which can leave you with persistent abdominal pain.

3. Generalised Pain: This kind of pain occurs in the overall area all around the stomach and may point at the presence of conditions like Crohn's Disease, a traumatic injury, appendicitis, flu, or even a urinary tract infection. Further, when the gas settles and tightens the stomach due to the inability to pass a motion on a normal, regular basis, this may be termed as constipation. This also leads to abdomen pain.

4. Localised Lower Abdomen Pain: Pain that is found specifically in the lower area of the abdomen can be caused due to appendicitis, obstruction or blockage in the intestine or colon, and other ailments. This pain can also be accompanied by nausea and vomiting.

5. Localised Upper Abdomen Pain: This kind of pain may emanate due to the presence of gallstones, liver inflammation or hepatitis, pneumonia, or even in the middle of a heart attack.

6. Localised Centre Abdomen Pain: Pain in the centre part of the stomach or abdomen may be caused due to gastroenteritis, an injury or even the accumulation of waste products in the body, otherwise known as uraemia.

7. Abdomen Pain and Women: For women, such localised pain may be caused due to pelvic inflammatory disease, urinary tract infection, endometriosis, ectopic pregnancy, menstrual cramps which are also called dysmenorrhoea, and fibroids. Miscarriages can also cause pain in this part of the abdomen, for women.

8. Renal Stones: Renal stones or stone in kidney is one of the most common cause of abdomen pain. The pain caused by kidney stone is such that it can make a patient roll in bed and this pain may radiate to toward the groin as well.

Persistent pain and nausea that come with vomiting and finally give rise to blood in the vomit or stool should be checked by the doctor immediately, so as to rule out any serious ailment. Imaging tests, ultrasound and an X-Ray can help in diagnosis.

Generally performed as an emergency surgery, an appendicectomy is performed to remove an infected or inflamed appendix. The most common question asked before such a procedure is whether removal of the appendix will cause problems in future. However, this tiny tube-like structure which is attached to the large intestine and is said to help you recover from diarrhoea or inflammations of the small or large intestines; its removal will not change how you recover from such infections either.

Conventional surgery: A conventional surgery generally requires the surgeon to make a small incision in the lower right side of your abdomen and remove the infected appendix. Such a procedure also allows the surgeon to clean abdominal cavity in case the appendix has ruptured. This method of surgery is also chosen when the patient has had abdominal surgery in the past.
Laparoscopic surgery: This is a much more modern method to surgically remove an infected appendix. The surgeon makes a small incision just enough to fit a small tube called a cannula. The abdominal cavity is filled with carbon-dioxide and a laparoscope is guided through to see the area clearly. The surgeon then proceeds to tie up the appendix and remove it completely. The incisions on the body are closed, cleaned and dressed.
Reasons why a laparoscopic procedure is better for you:

The biggest advantage is cosmetic as there is a far smaller incision in laparoscopic procedures as compared to the conventional surgery where the incision is sealed with stitches and the scar may be permanent.
In fact, some very good and experienced laparoscopic surgeons are able to hide even these small incisions behind the pubic hairline make it almost invisible to the naked eye.
Thanks to technology, the size of the instruments and the cameras used are getting better with time. It is the use of such small instruments that allows you to have an almost painless and scarless recovery.
Another major advantage in undertaking such a procedure is fewer post-operative complications that are seen in such surgeries. Generally, in the traditional surgery, patients are kept under observation due to redness around the incision, a high-grade fever, stomach cramps, vomiting, chills or any other symptoms. These complications or symptoms can be greatly avoided with the laparoscopic procedure.
Most people would always prefer a shorter hospitalization and it is possible with the laparoscopic procedure as the recovery is quicker and you can get back to work within a few days.
Considering the fact that such a surgery is typically performed in an emergency and a laparoscopic surgery offers a much better chance of quick and easy recovery, this is the best option for an appendicectomy.

Even Roald Dahl faked having appendicitis in his famous book, but, what exactly is appendicitis? Wouldn t it be a little interesting, to say the least, to find out what causes it and what treatment a person can expect to undergo in the case of getting it?

Quite simply, appendicitis is the name of the condition when the appendix swells up. Under normal circumstances, it is about three and a half inches in length. The ironic part about this is the fact that though appendicitis may cause tremendous pain and warrants surgery, no doctor is really aware of the reason why the appendix exists, in the first place! As a matter of fact, it is fully possible to live without an appendix and many people have not experienced any health problems after having their appendix removed.

While the appendix does not serve any properly defined function, this really does not mean that appendicitis is something that is not all that serious. In fact, if there is an explosion of the appendix, a person can die without very strong levels of medication in a time-bound manner!

So, what is the cause behind this scary prospect? Simply said, when the appendix gets blocked, the result is appendicitis. What blocks it? Well, it could be cancer, a foreign body or even stool! That being said, it is to be kept in mind that this is not the only reason as to why appendicitis exists. If there is an infection in the body, in response to it, the appendix may end up getting inflamed.

With the exception of a very small minority of cases in which very strong antibiotics are made use of in order to treat appendicitis, a surgery to remove the appendix is usually a given case scenario when a person has appendicitis. As a matter of fact, it is treated as an emergency and the doctors go ahead and start the treatment as soon as possible to avoid the possibility of the rupture of the appendix.

It usually takes about two or three weeks before a person can get back to normal activities though some gentle movement can be undertaken within about twelve hours since the end of the operation. There are two types of surgery. If a laparoscopic surgery is being performed, the recovery is relatively straightforward but if an open surgery is performed, the recovery can take more time and would require a greater amount of care.

Generally performed as emergency surgery, an appendicectomy is performed to remove an infected or inflamed appendix. The most common question asked before such a procedure is whether removal of the appendix will cause problems in future. However, this tiny tube-like structure which is attached to the large intestine and is said to help you recover from diarrhoea or inflammations of the small or large intestines; its removal will not change how you recover from such infections either.

Conventional surgery: A conventional surgery generally requires the surgeon to make a small incision in the lower right side of your abdomen and remove the infected appendix. Such a procedure also allows the surgeon to clean abdominal cavity in case the appendix has ruptured. This method of surgery is also chosen when the patient has had abdominal surgery in the past.
Laparoscopic surgery: This is a much more modern method to surgically remove an infected appendix. The surgeon makes a small incision just enough to fit a small tube called a cannula. The abdominal cavity is filled with carbon dioxide and a laparoscope is guided through to see the area clearly. The surgeon then proceeds to tie up the appendix and remove it completely. The incisions on the body are closed, cleaned and dressed.
Reasons why a laparoscopic procedure is better for you:

The biggest advantage is cosmetic as there is a far smaller incision in laparoscopic procedures as compared to the conventional surgery where the incision is sealed with stitches and the scar may be permanent.
In fact, some very good and experienced laparoscopic surgeons are able to hide even these small incisions behind the pubic hairline make it almost invisible to the naked eye.
Thanks to technology, the size of the instruments and the cameras used are getting better with time. It is the use of such small instruments that allows you to have an almost painless and scarless recovery.
Another major advantage in undertaking such a procedure is fewer post-operative complications that are seen in such surgeries. Generally, in the traditional surgery, patients are kept under observation due to redness around the incision, a high-grade fever, stomach cramps, vomiting, chills or any other symptoms. These complications or symptoms can be greatly avoided with the laparoscopic procedure.
Most people would always prefer a shorter hospitalization and it is possible with the laparoscopic procedure as the recovery is quicker and you can get back to work within a few days.
Considering the fact that such a surgery is typically performed in an emergency and a laparoscopic surgery offers a much better chance of quick and easy recovery, this is the best option for an appendicectomy.

A vermiform appendix is a small, blind ended hollow tube. It is closed from an end and attached at the other side to the caecum, which is a pouch shaped opening of the colon (large intestine), where the contents of the small intestine are emptied.

An appendix is considered to be a vestigial organ in the human body, with no clear function or any useful purpose in humans. It is, however, suspected that previously in humans it served the purpose of cultivation of gut flora that could be beneficial in repopulating the intestines after being affecting by a gut flora attacking disease.

It also supposedly functioned in the production of the endocrine cells during fetal life, whose function was regulation of hemostasis.

A possible function of exposing the white blood cells to antigens in the abdominal tract during the initial years of life that aided in the stimulation of production of antibody and thus regulating the immune reactions in the gastro-intestinal tract is also speculated. An evolutionary disappearance of the appendix has been proved in humans. If an appendix is present in the body and undergoes any kind of blockage, it can lead to appendicitis which is a very painful and a potentially fatal inflammation.

The appendix is around 3-5 inches in length and 0.4-0.5 inches in width. Cavity of the appendix is narrow at the end where it joins the cecum. It constitutes of muscular walls that aid in expulsion of mucous secretions of the walls of appendix into the cecum. A blockage to the opening of appendix that prevents the expulsion of the mucus secretions of the cecum cause appendicitis.

A fecalith, a solidified mass of the fecal matter is a common source of blockage of the appendix. Obstruction can also be a result of enlarged lymphoid follicles, worms in the intestine, trauma or tumors. The mucus secretions get collected in the appendix causing an edema and the distension of the organ itself.

With an increase in the distension of the organ, blood supply is affected. Discontinuation of the blood supply to the organ cause death due to necrosis of the appendiceal tissues.

Certain micro-organisms like the Yersinia species, Actinomyces, Mycobacteria species, Histoplasma species, viral agents like Cytomegalovirus, Adenovirus are implicated in the pathology of appendicitis. Microbial load on the necrosed organ further worsens the inflammation. Increased distension of the inflamed organ can cause it to burst and spill the contents into the abdominal cavity.

The membranes that line the abdominal cavity and form the covering of the abdominal organs is known as the peritoneum. Spilling of the mucus contents from the appendix may affect the peritoneum too.

The presenting symptom of appendicitis is moderate to severe pain in the abdomen. With the progression of infection, pain becomes localized to the lower right part of abdomen called as the McBurney s point . Other common symptoms are abdominal tenderness, a progressive worsening of pain, pain during coughing or sneezing, nausea, vomiting, diarrhea, difficulty or inability to pass gas, fever, acute constipation, loss of appetite and sometimes even a urinary tract infection.

Appendicitis is diagnosed on the basis of a patient's history and physical examination by the physician. For a confirmatory diagnosis white blood cell count, a urine analysis, abdominal X-ray, barium enema, ultrasonography of the abdomen, computerized tomography scan, and laparoscopy can be advised.

In patients with a mild and confined appendicitis, antibiotics treatment is sufficient to resolve inflammation. The appendix may be removed later if required. The most common treatment of appendicitis is an appendectomy, where the inflamed appendix is removed before it bursts. Surgical removal of appendix remains the most sought after treatment option by the physicians.

In an open appendectomy, an incision of two to three inches in length is made on the skin and the passed the layers of abdominal wall over the location of appendix. The appendix is freed from its mesenteric attachment to the colon and obliterating the opening on the colon with sutures. Pus is drained and the incision is closed.

Nowadays, to ensure minimum invasion, laparoscopic surgery also known as the key-hole surgery is done. It causes a minimal loss of blood, less scar tissue formation and quicker healing.