WHAT IS THE APPENDIX?

The appendix produces a bacteria destroying protein called immunoglobulins which help fight

infection in the body. Its function, however, is not essential. People who have had

appendectomies do not have an increased risk toward infection. Other organs in the body take

over this function once the appendix has been removed.

 

WHAT IS A LAPAROSCOPIC APPENDECTOMY?

 

Appendicitis is one of the most common surgical problems. One out of every 2,000 people has

an appendectomy sometime during their lifetime. Treatment requires an operation to remove the

infected appendix. Traditionally, the appendix is removed through an incision in the right lower

abdominal wall.

In most laparoscopic appendectomies, surgeons operate through 3 small incisions (each ¼ to

½ inch) while watching an enlarged image of the patient's internal organs on a television

monitor. In some cases, one of the small openings may be lengthened to 2 or 3 inches to

complete the procedure.

 

ADVANTAGES OF LAPAROSCOPIC APPENDECTOMY

Results may vary depending upon the type of procedure and patient's overall condition.

Common advantages are:

Less postoperative pain

May shorten hospital stay

May result in a quicker return to bowel function

Quicker return to normal activity

Better cosmetic results

 

ARE YOU A CANDIDATE FOR LAPAROSCOPIC APPENDECTOMY?

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Although laparoscopic appendectomy has many benefits, it may not be appropriate for some

patients. Early, non-ruptured appendicitis usually can be removed laparoscopically.

Laparoscopic appendectomy is more difficult to perform if there is advanced infection or the

appendix has ruptured. A traditional, open procedure using a larger incision may be required to

safely remove the infected appendix in these patients.

 

HOW IS LAPAROSCOPIC APPENDECTOMY PERFORMED?

 

The words "laparoscopic" and "open" appendectomy describes the techniques a surgeon uses

to gain access to the internal surgery site.

Most laparoscopic appendectomies start the same way. Using a cannula (a narrow tube-like

instrument), the surgeon enters the abdomen. A laparoscope (a tiny telescope connected to a

video camera) is inserted through a cannula, giving the surgeon a magnified view of the

patient's internal organs on a television monitor. Several other cannulas are inserted to allow

the surgeon to work inside and remove the appendix. The entire procedure may be completed

through the cannulas or by lengthening one of the small cannula incisions. A drain may be

placed during the procedure. This will be removed before you leave the hospital.

 

WHAT HAPPENS IF THE OPERATION CANNOT BE PERFORMED

OR COMPLETED BY THE LAPAROSCOPIC METHOD?

In a small number of patients the laparoscopic method is not feasible because of the inability to

visualize or handle the organs effectively. When the surgeon feels that it is safest to convert the

laparoscopic procedure to an open one, this is not a complication, but rather sound surgical

judgment. Factors that may increase the possibility of converting to the "open" procedure may

include:

• Extensive infection and/or abscess

• A perforated appendix

• Obesity

• A history of prior abdominal surgery causing dense scar tissue

• Inability to visualize organs

• Bleeding problems during the operation

• The decision to perform the open procedure is a judgment decision made by your surgeon

• either before or during the actual operation. The decision to convert to an open procedure is

• strictly based on patient safety

 

WHAT SHOULD I EXPECT AFTER SURGERY?

 

After the operation, it is important to follow your doctor's instructions. Although many people feel

better in just a few days, remember that your body needs time to heal.

You are encouraged to be out of bed the day after surgery and to walk. This will help

diminish the risk of blood clots in your legs and of soreness in your muscles.

You will probably be able to get back to most of your normal activities in one to two

weeks time. These activities include showering, driving, walking up stairs, working and

engaging in sexual intercourse.

If you have prolonged soreness or are getting no relief from the prescribed pain

medication, you should notify your surgeon.

You should call your surgeon and schedule a follow up appointment for about 1-2 weeks

following your operation.

 

WHAT COMPLICATIONS CAN OCCUR?

 

As with any operation, there are risks including the risk of complications. However, the risk of

one of these complications occurring is no higher than if the operation was done with the open

technique.

Bleeding

Infection

Removal of a normal appendix

A leak at the edge of the colon where the appendix was removed

Injury to adjacent organs such as the small intestine, ureter, or bladder.

Blood clot to the lungs

It is important for you to recognize the early signs of possible complications. Contact your

surgeon if you have severe abdominal pain, fever, chills or rectal bleeding.

 

WHEN TO CALL YOUR DOCTOR

 

Be sure to call your physician or surgeon if you develop any of the following:

Persistent fever over 101 degrees F (39 C)

Bleeding

Increasing abdominal swelling

Pain that is not relieved by your medications

Persistent nausea or vomiting

Chills

Persistent cough or shortness of breath

Purulent drainage (pus) from any incision

Redness surrounding any of your incisions that is worsening or getting bigger

You are unable to eat or drink liquids