What is the Surgical Procedure for Removing the Appendix?
An appendicectomy is a surgical operation which removes the appendix – the worm-shaped tube that hangs into the lower abdominal cavity from the first segment of the large intestine.
In humans the appendix has no known purpose, although some researchers believe that it may have performed some function at an earlier stage in our development.
Most people never have any trouble from their appendix. However, for reason that are not fully understood, this organ does sometimes become inflamed and filled with pus – a condition known as appendicitis.
Although appendicitis can occur at any age, it is most commonly experienced by young adults, and rarely by children under two years of age. Indeed, only one person in 500 has an attack of appendicitis.
How does Appendicitis develop?
Abdominal pain is the hallmark of appendicitis, usually starting in the mid-abdomen, before travelling down to the right, to the area over the appendix. Symptoms such as nausea, vomiting and constipation may also be experienced.
If left untreated, the inflammation may worsen until the appendix ruptures. The contents of the appendix, which include faecal material and bacteria, then spill into the normally sterile peritoneal cavity.
This can lead to peritonitis, a life-threatening inflammation of the peritoneum (abdominal lining). Abscesses may develop, threatening adjacent organs with infection. The passage of food through the intestines slows or stops. Shock, intestinal blockage, intense pain, and even death, may follow.
The diagnosis of appendicitis is mainly clinical. Laparoscopy is now commonly used for investigation and, if necessary, the removal of the appendix.
This procedure involves looking into the abdominal cavity with a small telescope. Surgeons cannot predict whether or not an inflamed appendix will rupture. If they suspect abdominal pain is caused by appendicitis, they will remove the appendix as soon as possible in case a rupture occurs.
Sometimes the pain is incorrectly diagnosed, and surgeons find the appendix is healthy. However, with the advent of laparoscopy, misdiagnosis is becoming a thing of the past.
What happens during an Appendicectomy?
Before the operation the patient will be sedated with a tranquillizer and then given a general anaesthetic.
The surgeon cleans the skin over the site of the appendix with an antiseptic solution and makes an incision through the skin, underlying layers of fat and the muscle, to expose the appendix.
The blood vessels leading to the appendix are tied off with sutures (stitches) and the inflamed organ is snipped off at its base. The base is buried in the wall of the intestine using a purse-string suture.
A drain may be left in the wound temporarily to remove any pus and other fluids which collect. The surgeon then repairs each tissue layer until reaching the incision, which is closed with more sutures.
If a laparoscope is used, the surgeon is able to make smaller incisions in the skin and to dissect the appendix inside the body before removing it.
The operation is more complicated if the appendix ruptures and abscesses have formed. These must be drained, so tubes may be left in the surgical wound to allow the continued removal of pus and fluids after the incision is closed. Doses of antibiotics are given to resolve the peritonitis.
Is an Appendicectomy dangerous?
An appendicectomy is a standard, safe operation that is usually followed by a rapid recovery. It makes about half an hour. However, complications may sometimes set in from the accidental release of tiny amount of infected matter into the peritoneum during the operation.
For this reason, antibiotics are usually prescribed routinely in order to prevent or treat any infection of this nature.
Warning / Precaution
Constipation commonly accompanies appendicitis. Taking a laxative increases the chance that the inflamed appendix will rupture.
Never take a laxative if there is abdominal pain, vomiting, or other symptoms suggesting the possibility of appendicitis.
Children frequently complain of stomach-aches. The symptom is usually nothing to worry about, but if the pain seems unusual or intense, or if it is accompanied by a fever, nausea, vomiting, or other symptoms, you should see your doctor.
Any severe abdominal pain which persists for more than four hours will require medical attention.