What is an appendectomy?
An appendectomy is the surgical removal of the appendix, a small appendage of the large intestine. Colloquially, this procedure is also referred to as appendectomy – a not entirely correct term, as the appendix is directly attached to the appendix, but is a separate section of the intestine. In addition, the appendix itself is not usually removed during an appendectomy.
When do you perform an appendectomy?
The most common reason for an appendectomy is acute inflammation of the appendix (appendicitis) – colloquially known as appendicitis. Typical symptoms include rapid onset and severe lower abdominal pain, nausea, vomiting and fever.
While appendicitis was often fatal in the past, it can now be quickly cured with the help of appendectomy. For this reason, doctors aim for a quick operation if there is a well-founded suspicion, so that the inflamed appendix does not rupture and cause a dangerous peritonitis.
Other reasons for an appendectomy are long-standing lower abdominal pain after other causes such as inflammation of the colon or fallopian tube have been ruled out. If cell changes in the appendix are detected during major abdominal surgery, the surgeon removes it to rule out subsequent cancer.
The operation is performed under general anesthesia. In the case of an emergency appendectomy, for example in the case of acute appendicitis, a gastric tube may be inserted to reduce the pressure in the gastrointestinal tract and thus prevent vomiting.
When possible, surgeons nowadays perform a laparoscopic appendectomy – that is, removal of the appendix during a laparoscopy. This is less severe than a traditional procedure because the surgeon only makes small incisions for the working instruments (trocars).
Procedure of appendectomy
Here’s how laparoscopic appendectomy works:
After the surgeon washes, disinfects and covers the surgical area with sterile drapes, he or she incises the skin in the right and left lower abdomen and below the belly button about one centimeter each.
With the aid of the two working trocars and the optic trocar, which contains a camera, he now traces the inflamed appendix and separates it from the remaining tissue. If larger areas are already inflamed, he may also have to remove the entire appendix.
Finally, the incision is sutured in several layers. A pathologist examines the inflamed appendix to confirm the diagnosis.
What are the risks of appendectomy?
Wound healing problems can occur after surgery, sometimes necessitating a repeat procedure.
In addition, despite the preventive administration of antibiotics, the wound may become infected. As a result, an abscess, i.e. an encapsulated collection of pus, can form. This must be operated on to prevent the infection from spreading. Such infections can cause peritonitis and intestinal paralysis, which can also result in surgery.
Rarely, patients develop so-called scar hernias after appendectomy. In this case, the tissue of the surgical scar moves apart, and abdominal contents bulge out. Often, the scar then needs to be operated on and reinforced to prevent parts of the intestine from leaking out.
What do I need to be aware of after an appendectomy?
In consultation with your doctor, you may be allowed to eat and drink again within the first day after surgery to keep the bowel active. If further recovery goes well, you may be discharged from the hospital after only four to six days. After about ten days, your family doctor will remove the skin sutures.
