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An appendectomy, also termed appendicectomy, is a surgical operation in which the vermiform appendix is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acute appendicitis. Appendectomy may be performed laparoscopically or as an open operation.


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What is Acute Appendicitis?

Acute Appendicitis is one of the commonest surgical emergencies occurring due to acute inflammation or infection of the Appendix. The Appendix is a small tubular structure found attached to the Caecum, which is the first part of the Large Intestine(Colon), situated in the right lower quadrant of the abdomen.

What are the risks of the appendicectomy procedure?

As with any surgery there are certain risks associated with the procedure. Clearly one must understand that the surgery is performed only when it is deemed that the benefit of Surgery is far greater than the risks involved.

Specific to an appendicectomy, the risks are related to the degree of infection in the Appendix. Patients with complicated or ruptured Appendicitis can have the following specific issues:

1. Recurrent infection leading to abscess formation.

2. Leakage from the Appendicular base.

3. Postoperative ileus-gaseous distension of the small intestine.

4. Postoperative sepsis syndrome- a rare life-threatening situation where the infection causes life-threatening dysfunction of multiple organ systems, usually seen in very late cases with diseases like Diabetes or compromised immunity.

Is Appendicectomy Surgery mandatory?

Appendicectomy i.e removal of the Appendix is the Gold Standard for treatment of acute appendicitis. However, in certain situations surgery may be deferred to a later date or indefinitely:

  1. Appendicular lump formation: This is a situation where due to a delay in the presentation the Appendicitis has been “walled off” by the Omentum and small intestine forming a mass around the Appendix. This is nature’s way of preventing the infection from spreading in the abdomen. It is best to treat this with antibiotics and defer Surgery to a few weeks later when the mass has resolved.
  2. Some cases of mild Appendicitis where the inflammation is resolving rapidly and spontaneously with or without antibiotics. In this situation the Surgery may be deferred to the next episode of inflammation. It is a recognised fact that the subsequent Surgery can be more difficult due to adhesions and the possibility of an early rupture of the Appendix.
  3. Moribund patient: The very rare situation where the patient is moribund and considered unfit for an anaesthetic or surgery due to pre-existing medical conditions.

When can I go home?

Most patients can go home a day after the surgery. In cases where the Appendicitis has been complicated by a rupture or abscess formation, or sometimes due to other conditions, the discharge may be delayed by a few days.

What are the symptoms of Acute appendicitis and how is it diagnosed?

Acute Appendicitis can present with a variety of symptoms, which can sometimes be confusing. The most common symptoms are pain and uneasiness around the belly button(Umbilicus) which later moves to the right lower quadrant of the abdomen. This may be associated with nausea and vomiting. Occasionally the patient may have loose stools or pain lower down in the abdomen on the right side or towards the back, due to the variability in positions of the Appendix.

A diagnosis of Acute Appendicitis is made by a combination of a clinical suspicion that is confirmed by some blood tests and an ultrasound scan or a CT Scan of the Abdomen- Pelvis.

Once confirmed, the gold standard of treatment for Appendicitis is Appendicectomy.

What is an Appendicectomy?

Appendicectomy is a surgical procedure to remove the Appendix. Most of the time the procedure is done Laparoscopically i.e by Keyhole Surgery. In this method,3-4 small cuts are made on the abdominal wall to introduce a camera and instruments. The cuts vary between 5 and 10mm.

However, in some complicated situations, the surgery would be performed by the open technique, which entails cutting a few centimeters on the abdomen to remove the inflamed Appendix.

In either of the methods, if the Surgeon deems it necessary, a tube drain may be placed to vent out the infected fluid. This is usually removed after a few days. Both the methods entail giving the patient a General anaesthetic.

Will Appendicectomy surgery be painful?

It is normal to have some pain in your tummy and around the wound for a few days after your surgery. This can be managed with regular painkillers. Your tummy may feel bloated afterward, but this will settle in time. If you have had a keyhole(Laparoscopic) procedure, you may experience some pain in your shoulder. This is due to the air insufflated along with the instruments, which gets absorbed into the body. Walking around can help this to improve. You may also notice that you have a sore throat afterward. This is a transient sensation and is due to the breathing tube placed in your throat for the general anaesthetic.

How long before I am back to my normal activities after appendicectomy Surgery?

Most patients can get back to their routines in about a week after the surgery(Laparoscopic). This may change depending on a variety of factors like the severity of the Appendicitis, pain threshold of the patient, intensity of the patient’s routine and pre-existing conditions to name a few.


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