A laparoscopic appendectomy is the surgical removal of your appendix through a minimally invasive technique. Depending on your surgical condition you may have to have your appendix removed via an open technique for instance if your appendix has ruptured.
Your appendix is a worm-shaped hollow pouch attached to the cecum, the beginning of your large intestine, while the other side is sealed at the end. If the appendix becomes infected (appendicitis), the infected appendix must be surgically removed (emergency appendectomy) before a hole develops in the appendix and spreads the infection to the entire abdominal space (peritonitis). Appendectomies are performed to treat appendicitis, an inflamed and infected appendix.
Symptoms of Appendicitis
- Abdominal pain that begins in the upper-middle of your abdomen and then develops into sharp localized pain. Pain may be worse when walking or coughing.
- Chills and shaking
- Fever (usually occurs within several hours)
- Loss of appetite
- Rectal tenderness
Causes of Appendicitis
The cause of appendicitis is usually unknown. Appendicitis may occur after a viral infection in your digestive tract, or when the tube connecting the large intestine and appendix is blocked or trapped by stool.
Appendectomies are usually carried out on an emergency basis to treat appendicitis. There are no alternatives, due to the serious consequence of not removing your inflamed appendix: a ruptured appendix and peritonitis, a life-threatening emergency.
This approach involves four incisions, each about 1 in (2.5 cm) in length, are made in different areas of the abdomen. One incision is near your umbilicus or navel, and one is between the umbilicus and the pubic bone. Two other incisions are smaller and are on the right side of your lower abdomen. The surgeon passes a camera and laparoscopic instruments through small incisions and can visually examine the abdominal organs. Your appendix is located and removed. The place where the appendix was formerly attached, your cecum, is stitched. The instruments are removed, and then all of the incisions are closed.
A skilled surgeon can perform either a laparoscopic appendectomy (LA) or a traditional appendectomy (TA), in less than an hour. But the laparoscopic approach can take longer to complete depending on the surgeon and any complications you may have.
When Is A Laparoscopic Appendectomy Required?
A laparoscopic appendectomy is of particular benefit to women who are difficult to diagnose because of gynecological disease. If you are prone to endometriosis, pelvic inflammatory disease, ruptured ovarian follicles, ruptured ovarian cysts, and tubal pregnancies they may be the source of your pain and not appendicitis. If a laparoscopic appendectomy is performed, your pelvic organs can be thoroughly examined and diagnosed before your appendix is removed. Most surgeons decide whether to perform a laparoscopic appendectomy or an open appendectomy based on the individual needs and your medical circumstances.
If you have cardiac diseases, you’re not normally a great candidate for a laparoscopic appendectomy. Your surgeon will discuss this with you. Each patient is different.
- Blood and urine tests
- CT scan
- Physical exam
The hospital staff will start you on IV fluids and antibiotics right away. Since appendicitis is an emergency condition, surgery is almost always done as soon as possible after your diagnosis is made.
Risks of Appendectomies
Problems from appendectomies (especially laparoscopic appendectomy) are rare, but all procedures have some risk. Your doctor will review potential problems with you.
- Damage to other organs
- Reaction to anesthesia
- Blockage of the bowel
Complications can occur if you:
- Drink alcohol
- Chronic diseases, such as diabetes and obesity
The overall complication rate of a laparoscopic appendectomy depends upon the status of the appendix at the time it’s removed. Laparoscopic appendectomies are not usually performed if the appendix has ruptured.
Recovering from Appendectomy
Recovering from your appendectomy is similar to other operations. You are allowed to eat when your stomach and intestines are starting to function again. Usually, your first meal is a clear liquid diet—broth, juice, soda pop, and gelatin. If you can tolerate this meal, your next meal is a regular diet. You will be asked to walk and resume your regular physical activities as soon as you can. Most patients can return to work and strenuous activity within one to three weeks after the operation.
The complications associated with undiagnosed, misdiagnosed, or delayed diagnosis of appendicitis are significant, leading to surgeons performing an appendectomy any time they feel appendicitis is the diagnosis. Approximately 20% of the time, a normal appendix will be removed.
Call your doctor immediately if you experience any of these:
- A cough, shortness of breath, chest pain, or severe nausea or vomiting
- Increased abdominal pain
- Lightheadedness or fainting
- Signs of infection, including fever and chills
- Passing blood in the stool
- Persistent nausea and/or vomiting
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision sites
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