How is Appendectomy performed on patients ?
Appendectomy is the surgical procedure of removing the appendix from the body. It is done by making a 2- to 3-inch incision in the skin layers where the appendix is located. The appendix is located in the right lower portion of the abdomen. The area where the appendix is located in inspected first and upon ascertaining that no other problems are present, the appendix is severed.
The removal of appendix is done by severing the appendix from its mesentery or that which is a double-layered supporting membrane of the peritoneum attached to the abdomen and large intestine. The severance of the appendix shall cause a hole in the large intestine where the appendix is removed which necessitates suturing over the hole to connect the tissues.
If pus is present, this should be drained out through the skin. Then, the incision is closed by suturing to connect the tissues.
With the advancement of technology, laparoscopy may be employed to effect appendectomy. Laparoscopy uses a laparoscope or that thin telescope with a camera attaced thereto and inserted into a tiny hole or incision, small enough to puncture the skin to accommodate the laparoscope through it.
Once appendicitis is confirmed, another incision or small puncture through the abdomen is made to insert special instruments to effect appendectomy. Herein, the surgeon is guided only by the monitor that displays the images in real time as the operation progresses. There are major advantages of laparoscopy over the classic surgical procedure. One advantage is: in laparoscopy, only small punctures are made in the skin, small enough to fit the laparoscope or thin tubes and special surgical equipment as compared to larger incisions made during the usual surgical procedure.
Smaller wounds mean lesser risk of infection, faster recovery period and less post-operative pain (post-operative pain is usually felt by patients from the incisions made in the skin after the anesthesia had subsided). The patient may then resume normal activities in considerably lesser period in the recovery room. Another health advantage of laparoscopy is: the surgeon can make a clear diagnosis on the patient as it can see clear images of what is inside the patient’s body as compared to the images generated from CT scan, ultrasound, and x-ray. Thus, a misdiagnosis of appendicitis can be ruled out.
To illustrate this, in some women with ruptured cyst in the ovary may be misdiagnosed as appendicitis as the symptoms are the same. With the help of laparoscopy, accurate diagnosis may be attained.
If during surgical procedure the appendix is not ruptured or still in tact buy only perforated, the patient may be discharged from the hospital within two days of post-operation recovery. However, in patients where the appendix is ruptured, the patient has to stay for quite longer period in the hospital, about a week or more, depending on the complications that may arise particularly if peritonitis has happened along with appendicitis.
Patients who have suffered peritonitis are more likely ill and placed under observation to avoid further complications or infections. In such cases, intravenous administration of antibiotics is prescribed to the patient to fight infection and increase resolution of any abscess that may have been still present.
In some cases, after opening up the abdomen where the appendix is supposed to be removed, the surgeon may see a normal appendix with no seeming perforation. In question as to whether the appendix must be removed, the surgeon usually opts to remove the same as it is a reasonable option to operate and sever a normal-appearing appendix in order to avoid future issues of mild or severe cases of appendix, aside from the fact that the incisions have been made and the patient’s abdomen has already been opened up for the operation and closing it without removing the appendix is quite unusually not the better option or not an option at all.