It’s not completely clear what role the appendix plays in the body, but removal of the organ via appendectomy doesn’t appear to have any long-term health consequences. Appendicitis is a condition in which the appendix becomes inflamed and filled with pus — a fluid made up of dead cells and inflammatory debris that often results from an infection. An appendectomy — surgery — has long been the standard treatment for appendicitis. But in recent years, an antibiotics-only, nonsurgical treatment for some types of appendicitis has gained increasing acceptance as a second option. Appendicitis pain resolves once the appendix is removed. (1) If appendicitis is not treated quickly, the appendix can rupture, releasing bacteria into the abdomen and potentially leading to a life-threatening infection called sepsis. This can happen within 48 to 72 hours of the onset of appendicitis symptoms. (2) Because of this danger, appendicitis is considered a medical emergency, and the appendix is typically removed within 24 hours of the condition’s being diagnosed. Complications have been shown to increase after that period of time. (3) In some cases where appendicitis is caught too late and the appendix has already ruptured — leading to infection or an abscess formation around the burst appendix — your medical team might decide to first treat the infection with antibiotics and then remove your appendix a few weeks later. (4) To further reduce your risk of complications, let your doctor know if you have:
Any allergiesA neurologic disease, such as a history of stroke or mini-strokeHeart diseaseLung disease, including asthma and emphysema or obstructive sleep apneaDiabetesKidney disease
You should also inform your doctor about your smoking, alcohol, and drug habits, and any supplements, herbal remedies, or drugs you are taking, such as blood thinners (including aspirin). (1) In the operating room, staff members will insert an intravenous (IV) line into your arm to provide you with fluids, antibiotics, and anesthesia medication. (2) To help you breathe, you may also be intubated, a procedure in which a plastic tube is inserted into your trachea (windpipe) and attached to a breathing machine. Your surgeon will then conduct the appendectomy while you’re unconscious. (2) During an open appendectomy, your surgeon will make a single, 2- to 4-inch-long incision in the lower right side of your abdomen and then cut through your fat and muscles to reach your appendix. Your surgeon will tie off your appendix from your large intestine, cut your appendix out, then wash the area with sterile fluid and close the incision. Laparoscopic appendectomy, on the other hand, is a bit more complicated. It begins with three small (less than an inch long) incisions in the abdomen. (5) In one slit, your surgeon will insert a nozzle to inflate the abdomen with carbon dioxide gas, allowing your appendix to be seen more easily. In a second incision, your surgeon will insert a laparoscope, a thin tube with a light and camera that displays your abdomen on a video monitor. Your surgeon will then use surgical instruments to remove your appendix through the third incision, using the video monitor to guide the way. Again, the procedure ends with washing the area and closing the incisions. (1) If, during a laparoscopic appendectomy, your surgeon discovers that you have a ruptured appendix or peritonitis (an infection of the membrane lining the abdomen), a switch to an open surgery may be required. (1) The laparoscopic procedure usually results in a shorter hospital stay, less pain, earlier recovery, and fewer complications. Most surgeons worldwide opt for the laparoscopic approach over open surgery in the treatment of both simple and complicated acute appendicitis. But it’s not yet unanimously considered the “gold standard,” because operating time takes longer, there’s increased intra-abdominal abscess risk, and it costs more than an open appendectomy. (6) Your surgeon may opt for an open surgery if you have:
Severe abdominal swelling, which could obstruct the surgeon’s viewIf your appendix has already ruptured (5)Peritonitis or abscess (7)Past or multiple previous abdominal surgeriesObesity (5)Pregnancy (8)
Do not lift heavy objects or participate in strenuous activity for three to five days after a laparoscopic appendectomy, or for 10 to 14 days after an open appendectomy. (1) To reduce pain, support your abdomen with a pillow or other soft object when you cough, laugh, sneeze, or make any other abdominal movements. (1) Here are some other helpful tips for your recovery:
Don’t fight sleep — your body needs rest to heal.Wash your hands before and after touching your incision area.Avoid baths until your stitches or Steri-Strips are removed.Don’t wear tight or rough clothing.Use engaging activities, such as music or games, to distract you from your pain.Return to work when you feel ready. Children may need some extra time to manage care of the incisions and infection risks before returning to school, so talk to your doctor about the appropriate recovery timeline. (9)
Additional reporting by Deborah Shapiro.
