Appendectomy

What is an Appendectomy?

Appendicitis has some common symptoms which include nausea, vomiting, constipation, loss of appetite, and pain. The pain is originally felt in the center of the abdomen and later gets extreme and shifts to the right lower abdomen. This pain can worsen with coughing, walking, or making other jolting movements. Sometimes, these symptoms may be missing and it becomes essential to consult an expert to evaluate the abdominal cavity to make a diagnosis.

What are the Types of Appendectomy?

There are typically two types of appendectomy procedures. Let's delve into both of them to understand what happens in these procedures.

1. Open Appendectomy: Open appendectomy is a standard and traditional method for an appendix operation. In this procedure, the surgeon creates an incision (about 2 to 4 inches long) in the lower right area of the abdomen, through which the appendix is pulled out. The procedure is generally favored in cases where there are complications or if laparoscopic surgery is not possible.
2. Laparoscopic Appendectomy: It is a new and minimally invasive option where the surgeon creates several tiny incisions in the belly or abdomen. Thereafter, a laparoscope (a thin, flexible tube with a camera and light) is pushed through one of the incisions to see the appendix and nearby areas. Other specialized surgical instruments are then inserted through the other incisions to pull the appendix. Laparoscopic appendectomy also known as keyhole surgery results in less pain, shorter hospital stays, and quicker recovery times than open appendectomy.

What Happens During an Appendix Removal Operation?

During an appendectomy, your general surgeon will commonly follow these steps:

1. Anesthesia: Once the patient is in the operating room, he/she is given general anesthesia to make sure they are in deep sleep, unconscious, and does not sense any pain during the procedure. The patient might also be given a muscle relaxant to avoid any muscle spasms.
2. Incision: Depending on whether the surgeon opts for an open or laparoscopic appendix operation, he/she will create either a single larger incision or several tiny incisions in the belly or abdomen.
3. Surgical procedure: During the laparoscopic procedure, the doctor will insert a small port into one of the incisions, and through that port, they’ll insert a tube known as a cannula. The cannula is used to expand (inflate) the abdominal cavity with carbon dioxide gas. This inflation results in more space for the procedure. After this, the doctor removes the cannula and inserts a laparoscope which has a light and camera attached to it. Through the camera, the surgery is displayed on a video screen, allowing the doctor to find the appendix and guide the instruments through the tiny incisions.
   
   If an open appendectomy procedure is chosen for appendix removal, your surgeon will make one huge incision in the lower right abdomen. They will then open the abdominal cavity to find the appendix beneath.
4. Appendix removal: Once the appendix is discovered in both procedures, the surgeon will detach it from the nearby tissues and blood vessels. The appendix is then tied off using stitches to control bleeding and is extracted from the body. Surplus fluids and gas are also drained through the incisions.
5. Closure: If it's an open appendix surgery, the surgeon will seal the incision using sutures or staples. In a laparoscopic appendectomy, the tiny incisions may be closed with sutures, surgical glue, or adhesive strips.

Appendectomy is a very common surgical procedure that lasts about 30 minutes to an hour, depending on the circumstances and the patient's conditions. However, as with any surgical procedure, there are some risks involved, like bleeding, infection, etc. The risks are typically low, but they vary depending on the patient's general health and the severity of the appendicitis.

What are the Advantages of Appendectomy?

The results of the surgery may vary depending on the type of procedure performed and the patient’s overall condition. However, some of the common advantages include:

• Less postoperative pain
• Shorter hospital stay in case of laparoscopic appendectomy
• May result in a faster return to bowel function
• Faster return to normal activity
• Better cosmetic outcomes
• Relief from symptoms like abdominal pain, vomiting, and fever.
• Low risk of recurrence
• Prevention of complications if appendicitis is left untreated, like peritonitis, abscess formation, and sepsis.

How to Prepare for Appendix Operation?

Preparing for your appendix operation involves taking several conscious steps to ensure a successful surgery and easy recovery. Here are some ways to prepare before the procedure:

1. Schedule an appointment with your surgeon to understand the complete procedure, examine your medical history, and address any questions you may have. Your healthcare provider may ask you to sign a consent form that permits him/her to do the surgery. It is essential to read the form carefully and ask queries if something is not clear.
2. Your healthcare provider may conduct a physical examination to ensure you are in good health before the surgery. He/she may also conduct blood and other diagnostic tests. Therefore, you must be mentally prepared for the examination and tests before the surgery.
3. Follow a good hygiene practice by taking a shower or bath before the surgery. Your healthcare team may provide certain instructions regarding cleaning the surgical area with antibacterial soap.
4. You must not eat or drink anything for 8 to 10 hours before the surgery. This means no food or drink after midnight. If your stomach has food and drink in it, there is a risk of vomiting or bringing up food into the throat. If this happens, the food could reach your lungs, impact your breathing, and cause damage to your lungs.
5. Make sure you convey your surgeon if you:
   • Think you may be pregnant or are pregnant
   • Are allergic to or sensitive to latex, medications, or anesthesia medications (local and general)
   • Have a history of bleeding conditions or are consuming any blood-thinning prescriptions, aspirin, or other medications that affect blood clotting.

What are the Recovery Tips to Follow After the Appendix Removal Operation?

Some of the steps to follow after your appendix operation include:

• Keep your incisions clean and dry. Also, if your wound appears to be red and swollen, don't panic, inflammation is a sign of the body's immune system coming in to protect the wound from infection.
• Don't remove the thin strips of tape surrounding your wound. It should fall off on its own in a week or so.
• Wear loose-fitting clothes like drawstring pants and a button-up shirt that can effortlessly slip over. This will help reduce pressure on your incisions.
• Don’t take a shower until the incisions are completely healed and your healthcare provider says it's OK.
• Don’t drive until you have stopped taking prescription pain medicine.
• Limit sports and strenuous activities like cycling, jogging, swimming, etc for at least 1 or 2 weeks. However, you can resume light activities around your home as soon as you feel stable and comfortable.
• Eat a bland, low-fat diet such as well-cooked soft cereals, mashed potatoes, plain toast, and low-fat yogurt at first. If that goes down well, you can slowly start your regular diet.