An appendectomy is surgery to remove the appendix when it is infected. This condition is called appendicitis. Appendectomy is a common emergency surgery. The appendix is a thin pouch that is attached to the large intestine. It sits in the lower right part of your belly. If you have appendicitis, your appendix must be removed right away. If not treated, your appendix can burst. This is a medical emergency. There are 2 types of surgery to remove the appendix. The standard method is an open appendectomy. A newer, less invasive method is a laparoscopic appendectomy.
Open appendectomy: A cut or incision about 2 to 4 inches long is made in the lower right-hand side of your belly or abdomen. The appendix is taken out through the incision.
Laparoscopic appendectomy: This method is less invasive. That means it’s done without a large incision. Instead, from 1 to 3 tiny cuts are made. A long, thin tube called a laparoscope is put into one of the incisions. It has a tiny video camera and surgical tools. The surgeon looks at a TV monitor to see inside your abdomen and guide the tools. The appendix is removed through one of the incisions. During a laparoscopic surgery, your provider may decide that an open appendectomy is needed.
If your appendix has burst and infection has spread, you may need an open appendectomy. A laparoscopic appendectomy may cause less pain and scarring than an open appendectomy. For either type of surgery, the scar is often hard to see once it has healed. Both types of surgery have low risk of complications. A laparoscopic appendectomy has a shorter hospital stay, shorter recovery time, and lower infection rates.
How do I prepare for an appendectomy? — You might need surgery right away after coming to the hospital with belly pain. Other times, the doctor can schedule a time for your surgery. The doctor or nurse will tell you if you need to do anything special to prepare.
Before your procedure, your doctor will do an exam. They might send you to get imaging tests, such as a CT scan or an ultrasound. Imaging tests create pictures of the inside of your body.
Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:
●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take or bring a bag with all of your medicines with you.
●Any allergies you have
●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.
You will also get information about:
●Eating and drinking before your surgery – The doctor will want you to "fast" before surgery. This means not eating or drinking anything for a period of time. In some cases, you might be allowed to have liquids until a short time before the procedure. The staff will talk with you about when to stop eating or drinking before your surgery.
●Lowering the risk of infection – You might be asked to wash the area with a special soap. The staff might also give you antibiotics before surgery.
●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.
Ask the doctor or nurse if you have questions or if there is anything you do not understand.
What happens during an appendectomy? — When it is time for the procedure:
●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.
●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Most appendectomies are done with general anesthesia. This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.
●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.
●The doctor will remove your appendix. If the appendix has burst, the doctor will wash away any material that spilled out when the appendix burst.
●The doctor will close your cuts (incisions) and cover them with clean bandages. In rare cases, the doctor will place a drain to get rid of extra fluid.
●The procedure usually takes 30 to 60 minutes.
What happens after an appendectomy? — After the procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. Most people can go home within 1 to 2 days after an appendectomy. Some people go home the same day of surgery.
As you recover:
●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.
●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.
●The staff will help you get out of bed and start moving around when you are ready.
●You will get medicine to help with pain if needed. You might need other medicines, too.
●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.
What are the risks of an appendectomy? — Your doctor will talk to you about all of the possible risks and answer your questions. Possible risks include:
●Bleeding
●Infection
●Injury to nearby organs
●Bowel contents might leak into the abdomen
●Abscess (a small pocket of pus)
●Ileus (when the bowel has trouble moving air, fluid, and food)
What else should I know? — Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor or nurse's instructions. Ask questions about anything you do not understand.
How can I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.
You should also:
●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision. If you had minimally invasive surgery, you might have more than 1 incision.
•Keep your incision dry and covered with a bandage for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry.
•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put your incision underwater, such as in a bath, pool, or lake. Getting it too wet can slow healing and raise your chance of getting an infection.
•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.
•Always wash your hands before and after you touch your incision or bandage.
●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.
•Keep coughing and doing deep breathing exercises for 7 to 10 days after you go home. This will help prevent lung infections. When you cough, sneeze, or do deep breathing exercises, press a pillow across your incision to support the wound and ease pain.
•Avoid heavy lifting, sports, and swimming for at least a week or 2. (Your doctor or nurse will tell you exactly how long to avoid these activities.)
●Eat when you are hungry – If you have an upset stomach, it might help to start with clear liquids and foods that are easy to digest, like soup, pudding, toast, or eggs. You can eat other types of foods when you feel ready.
●Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Follow all instructions for taking your pain medicines.
●Be aware that if you had minimally invasive surgery, you might have some pain in your shoulder. This is from the gas the doctor put into your belly for the surgery. Walking and moving around will help reduce the gas and ease the pain.
What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.
If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks. If the doctor used skin glue or tape, it will fall off on its own. Do not pick at it or try to remove it yourself.
When should I call the doctor? — Call for advice if:
●You have a fever of 100.4°F (38°C) or higher, or chills.
●You have redness or swelling around the incisions from your surgery.
●You have nausea or vomiting for more than 2 days after going home.
●You have any symptoms that worry you.
