Appendicitis Surgery / Appendectomy

The appendix is a small tail or outpouching in the large intestine / colon. The appendix is located in the lower right quadrant of the abdomen. Interestingly, the appendix serves no definitive purpose in the body, however, it represents a source of pain and cause for surgery in many patients. In fact, one in 20 people will have their appendix removed during their lifetime.

Appendicitis is the inflammation or infection of the appendix. Unfortunately, appendicitis is not very responsive to medical treatment (antibiotics) and usually gets worse very quickly. It often begins with pain in the center of the abdomen around the bellybutton and progresses to the lower right quadrant of the abdomen. This pain will become severe and piercing when the area is pressed and pressure is then relieved. Appendicitis may also present with fever, nausea, and other severe symptoms. If appendicitis is not treated quickly, the appendix can burst allowing fecal matter to enter the abdomen and cause infection known as peritonitis. The consequences can be severe, even leading to death if untreated. Therefore, it is best to treat appendicitis at its earliest signs.

Treatment for appendicitis

The definitive treatment for appendicitis is the removal of the inflamed appendix, known as an appendectomy. This procedure is straightforward and comes with few risks beyond the inherent risks of abdominal surgery such as pain, infection, and blood loss.

Many appendectomies are performed in a minimally invasive manner using a few small incisions in the lower abdomen to access the colon and remove the appendix. Certain situations may require open surgery or conversion during surgery. This may include an extensive infection or abscess, perforation of the appendix, extreme obesity, scar tissue in the surgical area and more.

The procedure takes about 45 minutes under general anesthesia and is usually performed in a hospital setting.

During laparoscopic surgery the appendix is cut away and removed through the largest of the ports used to access the abdomen. If open surgery is determined to be the best course, a single large incision will be made over the appendix, and the procedure will be performed in the same way. If the appendix has burst and the inside of the abdomen needs to be cleaned, an open procedure may be required.

Recovery after appendectomy

Patients will spend approximately 1 to 2 nights in the hospital depending the severity of the patient’s appendicitis, the patient’s general health, and the speed of which the patient recovers. Overall, laparoscopic appendectomy takes approximately one to two weeks and full recovery from open surgery takes approximately four to six week, during which time you will need to limit your physical activity. You will have a follow up appointment with your surgeon within two weeks.

You should contact our office if you experience any of the abnormal conditions that may indicate a complication or infection after surgery; vomiting, cramps, significant diarrhea or constipation, a fever over 101°, and/or worsening redness, swelling or foul-smelling discharge around the incision. Patients who have had open surgery have a higher risk of an incisional hernia. If you feel a bulge or protrusion around the incision site, please call our office.

Typically, there is not much time between the onset of symptoms of appendicitis and surgery, therefore many patients do not have the luxury of a consultation with their surgeon. However, if you are experiencing even minor pain in the lower right quadrant of your abdomen which worsens when you press down and let go, you should speak to your doctor, urgent care facility, or head to the ER right away. Appendicitis is an urgent condition that needs to be corrected surgically as soon as possible to avoid serious and severe complications.