Out of 100,000 people, it affects one in a hundred: because of an inflammation, the appendix, the vermiform appendix – incorrectly called the appendix – must be surgically removed, about 7 to 12 percent of the population gets it by the age of 30. With the help of laparoscopic surgery, also called minimally invasive surgery (MIS) or keyhole surgery, digital images can be taken during the operation and there are only very small scars. Other benefits include less blood loss, less pain and faster recovery after surgery.
Development of appendicitis
The appendix (appendix vermiformis, abbreviated appendix), which is about pencil-thick and about 8 cm long, is an appendage to the appendix proper. It lies between the small intestine and the large intestine and is actually just a fist-sized sack where digested waste ends up before being pushed from the small intestine into the large intestine. The mucosa of the appendix is similar in structure to that of the colon, but numerous lymph follicles are embedded in the wall, which serve to defend against infection, especially in childhood.
When a so-called appendicitis occurs, various factors are responsible for it: In most cases, a blockage inside the appendix is the cause, which subsequently leads to emptying disorders of the appendix.
Intestinal contents such as fecal stones, kinks in the appendix, scarred cords, and more rarely worms and tumors can block it. The consequence is then a bacterial inflammation of the appendix wall. Furthermore, appendicitis can also occur in general infectious diseases and in HIV infection and intestinal infections.
Appendicitis: symptoms
Inflammation of the appendix can be episodic and manifests as pain in the lower right abdomen, although it can also start in the upper abdomen and later become concentrated in the lower abdomen. If the disease spreads, the appendix may open, resulting in peritonitis, which then usually leads to prolonged treatment. In the case of repeated occurrence of this pain, it is essential to see a doctor.
Minimally invasive surgery for appendicitis.
In very many cases, the surgeon makes a laparoscopy – a laparoscopy. The laparoscopic method is particularly useful for unclear cases because the entire abdominal cavity can be viewed using a moving camera. Diseases that do not originate from the appendix can also be detected and, if necessary, treated in this way. Laparoscopic surgery is also called minimally invasive surgery (MIS) or keyhole surgery.
Digital imaging and video recording are possible during surgery. First, a gas (carbon dioxide) is introduced into the abdominal cavity through a needle. Through a small incision of about one centimeter in the navel area, a camera is inserted into the now distended abdominal cavity so that the surgeon can follow the course of the operation on the monitor.
The surgeon inserts working instruments via guide sleeves placed in the right and left lower abdomen. The appendix is visualized, vessels are electrically cauterized or interrupted with a suture. The surgeon then places a loop around the appendix, tightens it, and removes it via the guide sleeve. The gas is drained, and the skin incisions are sutured. A drain to drain the wound secretions must be applied for a few days. After four to five days, the patient can be discharged.