Definition
Appendectomy is colloquially referred to as the operation to remove the inflamed appendix. In reality, however, it is not the appendix (caecum), but the appendix vermiformis hanging from the appendix. For the sake of simplicity, however, the two terms will be used as synonyms in the following.
The appendectomy is also known medically as appendectomy (ectomy = cutting out). The most common reason for an appendectomy is an inflamed appendix (appendicitis), also called appendicitis. However, the appendix is often also removed during other abdominal operations in order to rule out later inflammation or complications.
Preparation of the appendectomy
In Germany, appendectomy is usually performed with an inpatient stay. An appendectomy is usually performed in the case of acute symptoms, for example because of an inflammation. The patient is either referred by his family doctor or comes directly to the hospital via the emergency room.
There the patient is admitted as an inpatient. First, diagnostic measures are taken, such as a physical examination, a blood sample and an ultrasound. If the suspicion is confirmed, the operation is planned.
The patient must be fasting for the operation. This means that they must not have eaten anything for at least six hours before the operation and not have had anything to drink for at least two hours before. In addition, an anaesthetist will assess the risk of anaesthesia, recommend which medications should not or should not be taken any more, and possibly carry out some tests (heart examination, lung tests). A general or visceral surgeon will inform the patient and, if necessary, the parents (in the case of underage patients) about the operation, the procedure and the possible complications of the operation, and then ask for their consent.
OP – Procedure of an appendectomy
As soon as the appropriate operating capacity has been created and all preparations have been completed, the patient is brought to the operating theatre by the nursing staff, also known as “smuggling in”. There, the patient is first taken to the anaesthesia preparation room. There he or she is expected by an anaesthetist and the anaesthetic nurse, who will take care of the induction of anaesthesia.
The anesthesiologist will again request the patient-specific data in order to summarize the most important data again and to rule out any confusion. Here, a venous access is usually, if not already done, placed in a vein in the back of the hand or arm. In addition, the patient is connected to the monitor, which measures blood pressure, heart rhythm and the oxygen content in the blood.
After the patient is finally given oxygen again via a mask, the doctor administers the anaesthetic medication and the patient falls asleep. The anaesthetist will then insert a breathing tube into the trachea and finally drive the patient to the operating theatre. The course of the appendectomy depends on whether an open or a laparoscopic (minimally invasive) operation is planned.
Usually this will be a laparoscopic operation. However, there are some exceptions where open surgery may be necessary. In open surgery, an approximately 6 cm long incision is made in the right lower abdomen, over which the entire procedure takes place.
In laparoscopic surgery, three surgical instruments (throcars) are inserted through three small, approximately 2 cm incisions. One of these incisions is located directly below the navel. A camera is inserted here.
The other two incisions are used to insert the robot-like throcars, which “extend” the surgeons’ hands and through which the operation is performed. In order to get an overview and to be able to work better, the abdomen is first inflated with gas (C02), which is released again after the operation. Through one (open surgery) or three (laparoscopic) skin incision(s) the appendix in the right lower abdomen is searched for.
The appendix (appendix), which is also located, is attached to the appendix. The surgeon will then clamp and sever the feeding vessels to cut off the blood supply. The appendix is removed and the stump is closed with sutures. Finally, the abdominal wall is sutured in layers and the skin is closed with staples or sutures. The patient is taken to the recovery room, where he or she must remain for about two hours until he or she can be brought back to a normal ward.
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