Appendectomy - How Is It Performed?

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 in 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 a 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, 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.