Appendix Surgery

Appendicectomy can sometimes be performed as an open operation. This involves a larger incision in the right lower abdomen which leads directly down to the appendix and it is removed under direct vision. The larger incision results in a slightly slower recovery, increased pain, and higher wound complication rate. This was previously the most common approach, however, nowadays it is reserved for specific cases of complex appendicitis given the advantages of newer keyhole surgery.

Managing appendicitis with surgery is the current standard of care. However, there is some evidence that treatment with antibiotics only may be effective in some patients. This approach may be a consideration if a patient is not fit to undergo any surgery and the appendicitis is only mildly inflamed. Patients who undergo this approach may not necessarily respond to treatment, may have a longer hospital stay or recurring bouts of appendicitis requiring surgery anyway. It is not appropriate is the appendix has burst.

Appendicectomy is generally considered low risk, however, complications can still occur as with any surgery. Complications include:

• General Anaesthesia Complications particularly relating to maintaining your breathing, heart function, and circulation.

• Damage to surrounding organs such as the bladder, bowel and urinary system.

• Leakage of digestive contents from a burst appendix. This can spread infection throughout the body

• Blood loss requiring re-operation or blood transfusion with its low risk of disease transmission

• DVT (blood clot in the deep leg veins)

• Shoulder / Wound Pain – this is temporary for the first few days.

• Hernias from the wounds <1%.

• Occasionally a different diagnosis may be found at the time of surgery and operation may need to be modified at the time of surgery accordingly.

• It is normal to feel tired after surgery.

• You will generally resume a normal diet on the same day and be ambulant.

• You will be expected to stay in hospital for an average of 1 to 3 nights however this may vary due to complexity of your surgery and occasionally you may require antibiotics in hospital.

• Most patients will have minimal pain. However, pain killers and anti-nausea medication will be available.

• Avoid strenuous exercises and lifting heavy weights for 3-4 weeks

• Please organise a friend or family member to pick you up from the hospital by on the day of discharge.

• Please avoid driving for the first 10 days after surgery

• A clinic review will be organised in 3-4 weeks to assess your recovered and appendix results. A letter will be sent to your GP