Appendix Surgery

Laparoscopic Appendicectomy – Surgical Removal of the Appendix

A laparoscopic appendicectomy is a keyhole surgical procedure performed for the treatment of an inflamed appendix (known as appendicitis). The appendix is a small worm-shaped sac that is attached to the bowel. The procedure involves detaching the appendix where it joins the bowel and removing it through a small keyhole incision and also washing out any infection. Without management of appendicitis, this condition can progress and spread infection throughout the body leading to serious organ failure and even death in rare cases. There are no known long-term problems living life without an appendix.

Who Gets Appendicitis?

Appendicitis is very common and can affect anyone even if you are fit and healthy. Some symptoms include:

  • Right-sided abdominal pain

  • Fever

  • Nausea

  • Loss of appetite

Appendix Surgery

The Procedure – Laparoscopic Appendicectomy

The Procedure – Laparoscopic Appendicectomy

Prior to the surgery Dr. Andrew Kiyingi may organise some tests which may include a blood test, ultrasound or even CT scan to prepare for surgery. As the procedure is performed under general anaesthesia, you will be reviewed by an anaesthetic doctor and will need to have an empty bladder as well as fast for 6hrs prior. No oral intake or chewing gum. Please advise us before surgery if you

  • Have any allergies

  • Are pregnant

  • Are on blood-thinning or any non-prescription medications.

During the procedure 3 to 4 small incisions (<2cm) will be made on your abdomen. Carbon dioxide gas will be used to expand your abdomen, allowing the organs to be seen. A special narrow camera called laparoscope, will be inserted through one incision and a video image will be relayed to a tv screen to allow the surgical team to perform the surgery. Further small instruments will be inserted through the other incisions as required to complete the operation.  Occasionally a small drain may be placed in the wound to drain any residual contaminated fluid. It may stay in for a few days. At the end of the procedure, the incisions are closed with dissolving sutures and covered with a waterproof dressing. The operation is generally very straight forward, however the severity of appendicitis can vary from patient to patient, making surgery more complex in some cases. The duration of surgery usually varies from 30 – 120mins. The appendix will be sent to lab for testing.

Open Appendicectomy

Open Appendicectomy

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.

Non-Operation

Non-Operation

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.

Risks of Appendix Surgery

Risks of Appendix Surgery

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.

Postoperative Care for Appendix Surgery

Postoperative Care for Appendix Surgery

  • 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

We Can Help.

Appendicitis is an emergency condition. If you are concerned, please see your GP for an urgent referral to see Dr. Andrew Kiyingi or go to an emergency department.