An appendectomy is the surgical removal of the appendix, a tube about six inches long or less that branches off the large intestine. The procedure is performed to treat appendicitis, an inflammation of the appendix caused by infection.
Acute appendicitis is the most common condition of the abdomen to require emergency surgery. Because of the likelihood of the appendix rupturing and causing a severe, life-threatening infection, the usual recommendation is that the appendix be removed as soon as possible.
Appendicitis occurs when the interior of the appendix becomes filled with something that causes it to swell, such as mucus, bacteria, foreign body, stool, or parasites. The appendix then becomes irritated and inflamed. Rupture (or perforation) occurs as holes develop in the walls of the appendix, allowing stool, mucus, and other substances to leak through and get inside the abdomen. An infection inside the abdomen known as peritonitis occurs when the appendix perforates.
Because of the risk of rupture, which may occur as soon as 48 to 72 hours after symptoms begin, appendicitis is considered an emergency and anyone with symptoms needs to see a doctor immediately.
Appendicitis may cause pain in the abdomen which may be described as follows:
May start in the area around the belly button, and move over to the lower right-hand side of the abdomen, but may also start in the lower right-hand side of the abdomen
Usually increases in severity as time passes
May become more severe with moving, taking deep breaths, being touched, and coughing or sneezing
May spread throughout the abdomen if the appendix ruptures
Other symptoms of appendicitis include, but are not limited to, nausea and vomiting, loss of appetite, fever and chills, constipation, diarrhea, inability to pass gas, and abdominal swelling.
The symptoms of appendicitis may resemble other medical conditions or problems. In addition, each individual may experience symptoms differently. Always consult your doctor for a diagnosis.
It is important that people with symptoms of appendicitis not take laxatives or enemas to relieve constipation, as these medications and procedures can cause the appendix to burst. In addition, pain medication should be avoided, as this can mask other symptoms.
The appendix may be removed in one of two ways:
Open method. In this method, a two- to three-inch incision is made in the lower right-hand side of the abdomen. The surgeon locates the appendix and removes it through the incision.
Laparoscopic method. This procedure uses several small incisions and three or more laparoscopes—small thin tubes with video cameras attached—to visualize the inside of the abdomen during the operation. The surgeon performs the surgery while looking at a TV monitor. The appendix is removed through one of the incisions.
During a laparoscopic appendectomy, your doctor may decide that an open appendectomy is needed.
A laparoscopic appendectomy may cause less pain and scarring than an open appendectomy, although even for open appendectomy, the scar is often hard to see once it has healed.
Open and laparoscopic techniques are thought to be comparable in terms of low rates of complications. However, length of hospital stay, length of overall recovery, and infection rates are reportedly lower with laparoscopic appendectomy.