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Appendectomy -- Open Surgery

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Appendectomy—Open Surgery

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Definition

An appendectomy is the removal of the appendix. The appendix is a pouch that is attached to the large intestine.

Reasons for Procedure

An appendectomy is often done as an emergency operation to treat appendicitis. Appendicitis is inflammation of the appendix. It can be caused by an infection or obstruction.
Inflamed Appendix
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Possible Complications

Complications are rare but no procedure is completely free of risk. Your doctor will review a list of possible complications, which may include:
  • Bleeding
  • Infection
  • Damage to other organs
  • Reaction to anesthesia
Some risk factors that make complications more likely include:

What to Expect

Prior to Procedure

Your doctor may do the following:
  • Physical exam
  • Blood and urine tests
  • Your doctor may need detailed pictures of your appendix. These can be made with:
  • X-rays
  • Ultrasound
  • CT scan
Antibiotics will be started right away. Appendicitis is an emergency condition. Surgery is almost always done right away.

Anesthesia

General anesthesia will be used. You will be asleep with a temporary breathing tube in place.

Description of the Procedure

A short incision will be made in the right lower abdomen. The doctor will be able to see the appendix through this cut. The appendix will be detached from surrounding tissue. The surgeon will stop any bleeding from blood vessels. The appendix will then be tied off and cut out. The incisions will then be closed with stitches or staples.
If the appendix has ruptured, a warm water solution mixed with antibiotics will be used to wash out the inside of the abdomen. A catheter (tube) will then be placed to drain any fluid that builds up. Sometimes, with a rupture, the surgeon will only close the muscle layers and leave the skin open. The open skin wound will then be packed with a moist gauze dressing.

After Procedure

The removed tissue is examined by a pathologist.

How Long Will It Take?

1-2 hours

Will It Hurt?

Anesthesia prevents pain during surgery. You may be given medicine to manage any pain.

Average Hospital Stay

You may be in the hospital for 0-3 days. If the appendix has ruptured, expect to stay for several days or more than a week.

Post-procedure Care

At the Hospital
  • You will be asked to get out of bed about six hours after surgery.
  • If your appendix ruptured, drainage tubes will be removed after a few days.
At Home
Recovery takes about 4-6 weeks. When you return home, do the following to help ensure a smooth recovery:
  • You may resume your normal diet as soon as possible.
  • You may be given antibiotics to fight infection. Take all the medications ordered even if you start to feel better.
  • Keep the incision area clean and dry.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Wash your hands before changing the dressing.
  • Rest and take it easy for 1-2 weeks.
  • Do not exercise or do heavy lifting for one or more weeks as directed by your doctor.
  • Slowly increase activities as approved by your doctor.
  • Be sure to follow your doctor's instructions.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occur:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Increased abdominal pain
  • Fainting or dizziness
  • Passing blood in the stool
In case of an emergency, call for medical help right away.

RESOURCES

American College of Surgeons http://www.facs.org

National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov

CANADIAN RESOURCES

Canadian Association of Gastroenterology http://www.cag-acg.org

Canadian Family Physician http://www.cfp.ca

References

Appendicitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 17, 2012. Accessed November 7, 2012.

Discharge instructions for an appendectomy. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/perc-about. Updated September 26, 2012. Accessed November 7, 2012.

Townsend C, Beauchamp DR, eds. Sabiston Textbook of Surgery. 17th ed. Philadelphia, PA: WB Saunders; 2003.

6/2/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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