Appendicectomy

• What is the appendix?
• Why is the appendix removed?
• How is the appendix removed
• What should i expect after surgery
• What are the risks for appendicectomy

Appendicectomy is a surgical procedure to remove the appendix from the abdomen. It can be performed either with a small incision on the abdomen or laparoscopically (key hole surgery). Below is a graphical representation of the Appendix. Acute appendicitis is the most common surgical emergency with a lifetime incidence of 6%. Treatment of acute appendicitis is appendicectomy. Other reasons for appendicectomy are suspicion of acute appendicitis, appendix mass and tumour of the appendix.

What is the appendix?

The appendix is a small, finger shaped pouch of intestine that extends from the caecum, which is the first part of the large intestine. It is found in the right lower quadrant of the abdomen. The purpose of the appendix is unknown, however it is not believed to have any significant function.

Why is the appendix removed?

When the appendix becomes inflamed, it is painful and if it ruptures (perforated appendix), it can leak infected fluid into the abdomen which causes peritonitis, which can be fatal.

How is the appendix removed?

The appendix can be removed by an appendicectomy, which an either be an open surgical procedure (traditional method), or via laparoscopic procedure (key hole surgery). Most studies have shown that there is minimal differences between open and key hole surgery for appendicitis in terms of infection, pain control after surgery, hospitalisation time and recovery. It is generally the surgeons preference as to whether an open or laparoscopic appendicectomy is performed.

What should I expect after surgery?

This depends on whether or not the appendix has perforated (ruptured). If there has been no perforation, you may be able to leave hospital as early as 1-2 days after surgery if there are no complications, pain is manageable on oral analgesics, you have no fever and you are able to eat and drink normally. If the appendix had perforated, you will need to stay in hospital for longer for treatment with antibiotics intravenously (into your veins via a drip). Normal activities including work can normally be resumed 1 to 3 weeks after surgery (consult your doctor if you do physical work).

What are the risks for appendicectomy?

As for all surgical procedures, appendicectomy contains risks.
These include:

• Bleeding
• Infection
• Damage to surrounding structures in the abdomen
• Risks of the anaesthetic

However, these risks are considered to be minimal, especially when appendicitis can be fatal if it leads to peritonitis.

References

1. Antibiotic. 2002. eTG complete [Internet]. Melbourne: Therapeutic Guidelines Limited; 2006 Jan. Accessed 2006 April 2 .
2. Goldberg, J. Hodin, R. Appendicitis in Adults. 2005. UpToDate.
3. Mazziotti, M. Minkes, R. Appendicitis: surgical perspective. eMedicine. 2004. Available at: http://www.emedicine.com/ped/topic2925.htm
4. Tjandra, J. Clune, G. Thomas, R. Textbook of Surgery. 2nd ed. Blackwell Publishing. 2001. Oxford.