Appendectomy: Treatment, Effect & Risks

Appendectomy is the surgical removal of the appendix vermiformis. The procedure is used when there is inflammation of the appendix vermiformis.

What is appendectomy?

Appendectomy is when the appendix vermiformis is surgically removed. Appendectomy is when the appendix vermiformis is surgically removed. This is done when there is inflammation of the appendix. Most people refer to this condition as appendicitis. The surgical removal of the appendix is called appendectomy. However, both are incorrect because only the appendix vermiformis is removed and not the entire appendix (caecum). The appendix vermiformis is the extension of the appendix, which reaches a length of about 10 centimeters. Due to the position of the appendix, which in a sense forms a dead end, inflammation can easily occur there, which then requires surgical treatment. Thus, this area has an entrance, but not an exit. The first successful appendectomy took place in 1735 at George’s Hospital in London. In this operation, the French surgeon Claudius Amyand (1680-1740) removed the appendix vermiformis of an eleven-year-old boy rather by accident.

Function, effect, and goals

An appendectomy is performed when the appendix vermiformis has become inflamed. The cause of the inflammation is usually the accumulation of digestive debris. This primarily includes fecal stones (hardened stool). Sometimes appendicitis is also caused by foreign bodies or swelling of the mucosa. These causes can lead to obstruction of the inside of the appendix, which in turn leads to bacterial inflammation. Appendectomy is especially common in children and young adults who are between the ages of 4 and 25. Appendectomy is often necessary because appendicitis carries the risk of life-threatening complications. For example, the inflamed wall of the intestine can tear, which physicians call a perforation or rupture of the appendix. Perforation of the vermiform appendix occurs in up to 30 percent of all patients. This prolapse occurs in most cases 24 to 36 hours after the onset of appendicitis. In very rare cases, surgery also takes place due to tumors within the appendix, which can be benign or malignant. These tumors tend to be discovered by chance during an abdominal endoscopy, as they do not cause any symptoms over a long period of time. An appendectomy, which takes place under general anesthesia, can be performed either as a laparotomy or as a laparoscopy. In a laparotomy, the surgeon makes an incision 6 centimeters long on the right lower abdomen. Then he seeks out the lower pole of the appendix. This is where the appendix vermiformis usually comes off. After pinching off the feeding blood vessels, the surgeon finally separates the appendix. A special suture, called a tobacco pouch suture, is used to suture the remaining stump. For safety, the doctor double sutures the wound. At the end of the appendectomy, he closes the abdominal wall again. Closing of the skin wound is done by stapling or suturing. However, the appendix vermiformis can also be removed by laparoscopy. This is a laparoscopic procedure called a laparoscopic appendectomy. The first step of the procedure is a small incision in the belly button region. This is followed by the insertion of an optical device including a camera into the patient’s abdominal cavity. To obtain a better overview, some gas is previously introduced into the abdomen by needle. This procedure allows the surgeon to get a better overview of the abdominal organs on the connected monitor. The next step is the insertion of the medical working instruments. Then the blood vessels of the appendix vermiformis are either cut off with a thread or electrically coked. After that, the surgeon pulls a loop around the appendix and tightens it. This is followed by the removal of the appendix vermiformis. After removal of the instruments, draining of the gas and suturing of the skin incisions take place.

Risks, side effects, and hazards

Complications from appendectomy are very rare.They are conceivable if adhesions or scarring already exist in the area of the appendix. However, these can also form after the operation, leading to the risk of intestinal obstruction. An undesirable side effect of appendectomy can be mechanical impairment of the abdominal organs, which in turn results in bleeding. The occurrence of abscesses in the abdominal cavity or life-threatening peritonitis is considered a particularly dangerous complication. Wound healing disorders and the excessive formation of scars are also conceivable. Occasionally, scar fractures also occur in the abdominal region. Furthermore, temporary sensory disturbances are conceivable, which are caused by nerve injury. Some patients suffer permanent pain after appendectomy. Also in the range of possibility are various allergic reactions. Surgery of the appendix vermiformis should not be performed only if the patient suffers from a very poor general condition or is not able to undergo anesthesia. However, this happens extremely rarely. After the operation, the patient initially remains under observation. From the second day on, it is normally possible to eat a light diet again. The stay in the hospital usually lasts three to five days, depending on the individual findings. Following a laparotomy, the patient must continue to rest for about four to six weeks. After a laparoscopy, the period of rest lasts only about 14 days.