Appendicitis Surgery, Here's What You Should Know

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Appendicitis Surgery, Here's What You Should Know
Appendicitis Surgery, Here's What You Should Know
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Appendectomy or appendectomy is an operation to remove the appendix or appendix that has become infected (appendicitis). The appendix is ​​a small sac-shaped organ that protrudes from the large intestine

Appendectomy is a medical emergency. This procedure is performed in situations where the appendix is ​​severely inflamed and in danger of bursting.

Appendicitis Surgery, Here's What You Should Know - Alodokter

Appendectomy can be performed using two techniques, namely:

Open appendectomy

Open appendectomy is performed by making a 5–10 cm long incision in the lower right part of the abdomen. This incision provides access to remove the appendix. After the appendix is ​​removed, the incision will be closed again.

Open appendectomy is generally performed when the patient's appendix has ruptured and the infection has spread. Open appendectomy has also become a common method of choice for patients who have had surgery on the abdomen.

Laparoscopic appendectomy

Laparoscopic appendectomy is performed by making 1-3 small incisions in the lower right part of the abdomen. After the incision is made, a laparoscope is inserted through the incision to remove the appendix. A laparoscope is a long, thin tube-shaped instrument equipped with a camera and surgical instruments.

When a laparoscopic appendectomy is performed, the doctor will decide whether to proceed with an open appendectomy or not. Compared to open appendicectomy, laparoscopic appendicectomy causes less pain and scarring.

Indications for Appendicitis Surgery

Appendectomy or appendectomy is an action taken to treat appendicitis or appendicitis that does not improve with medication. If not treated immediately, the appendix can rupture and be life threatening.

The symptoms that are usually experienced by people with appendicitis are:

  • Abdominal pain in the navel and spreads to the lower right part of the abdomen
  • Swelling in stomach
  • Stiff stomach muscles
  • Diarrhea
  • Constipation or constipation
  • Mild fever
  • Loss of appetite
  • Hard to fart
  • Nausea and vomiting

Appendicitis Surgery Alert

In general, there are no strict contraindications or exceptions for appendicitis patients to undergo appendectomy. However, appendectomy is usually not recommended in patients who also suffer from or have a history of inflammation of the connective tissue (phlegmon).

If there is an abscess or phlegmon in the area around the appendix, the doctor may prescribe antibiotics and perform fluid drainage (percutaneous drainage), before an appendectomy is performed.

Patients with the following conditions are also not recommended to undergo laparoscopic appendectomy:

  • I'm pregnant in the first trimester
  • Having a ruptured appendix
  • Has thick fat in the stomach, because the appendix will be difficult to see
  • Experiencing intestinal adhesions
  • Currently undergoing immunosuppressant therapy or radiotherapy
  • Suffering from blood clotting disorders (coagulopathy)
  • Suffering from portal hypertension, which is an increase in blood pressure in the portal vein which carries blood from the digestive organs to the liver

Before Appendicitis Surgery

Before an appendectomy, tell your doctor if you:

  • Pregnant
  • Has an allergy to latex or anesthetics
  • Currently taking certain medications, including herbal products and supplements
  • Suffering from another disease
  • Has a history of bleeding
  • Is undergoing therapy or treatment

Usually, patients are not allowed to eat and drink for at least 8 hours before surgery. Patients are required to be accompanied by family members or close relatives before and after surgery.

The doctor will check the patient's medical history and perform a physical examination to confirm the patient's condition before the appendectomy is performed. If necessary, the doctor will also perform laboratory tests, such as blood tests and scan tests.

Prior to surgery, there are several things the patient must do, namely:

  • Removing jewelry and other items that may interfere with the operation
  • Change into hospital clothes
  • Shaving the hair in the area to be operated on

After all the preparations are done, the patient will be asked to lie on his back on the operating table. After that, the doctor will give intravenous fluids containing drugs through an IV in the arm.

Furthermore, the patient will be given general anesthesia, so that the patient is unconscious during the operation. In some cases, local anesthesia can be used instead of general anesthesia.

Appendicitis Surgery Procedure

As explained earlier, appendectomy can be performed in two ways, namely open appendectomy and laparoscopic appendectomy. The following are the stages of an open appendectomy:

  • An incision is made in the lower right part of the abdomen.
  • The abdominal muscles will be separated and the abdomen will be opened.
  • The appendix is ​​tied with surgical thread, then cut.
  • If the appendix is ​​ruptured, the stomach will be washed using saline water.
  • Washing water, blood, and other body fluids around the operated area will be removed using a special suction device.
  • After the operation is completed, the abdominal muscles and the skin incision will be sutured, then covered with a bandage to prevent infection.
  • The excised appendix will be sent to the laboratory for analysis.

Slightly different from open appendectomy, the following are the stages of a laparoscopic appendectomy:

  • A small incision is made in the lower right part of the abdomen. Incisions can be made in several places to make it easier for surgical equipment to enter the abdomen.
  • Carbon dioxide gas is introduced into the abdomen through the incision that has been made to inflate the operating area and make it easier for the doctor to see the organ to be operated on.
  • The laparoscope is inserted through the incision to find the appendix.
  • The appendix is ​​then tied and sutured using thread, after which it is cut and removed.
  • Fluid and blood in the abdominal cavity and the area around the surgery site will be removed using a special suction device.
  • After the fluid is removed, the laparoscope is pulled out of the stomach. Carbon dioxide gas will come out through the incision hole.
  • After the operation is completed, the abdominal muscles and skin incisions will be sutured and then covered with a bandage to prevent infection.
  • The excised appendix will be sent to the laboratory for analysis.

During the surgical process, the patient's breathing will be assisted by a machine. The anesthesiologist will monitor the patient's heart rate, respiratory rate, blood pressure, and oxygen levels.

After Appendicitis Surgery

After the appendectomy is completed, the patient will be transferred to the recovery room. Patients will also receive further medical treatment as follows:

  • Monitoring of physical conditions, such as respiratory rate, heart rate, and blood pressure
  • Providing painkillers such as ketorolac, both in the form of oral drugs and injections
  • Installation of a tube from the nose to the stomach to remove water and air in the stomach if necessary

Patients can drink water a few hours after appendectomy and gradually eat solid food if their physical condition improves.

Patients undergoing laparoscopic appendicectomy are allowed to get out of bed a few hours after surgery, while patients undergoing open appendectomy may only get out of bed a few days after surgery.

Most patients can go home after 1-2 days of hospitalization. Patients are advised not to return to their normal activities immediately until 2–4 weeks after undergoing appendectomy.

Patients also need to do recovery and treatment independently at home by:

  • Keep the stitches dry and clean

    Make sure the stitches are always dry and clean to avoid infection. The doctor will give instructions on how to take a shower without wetting the incision. The sutures will be removed by the doctor after the wound is closed and healed properly.

  • Using pain relievers as recommendedSurgery incisions can cause pain, especially after standing for a long time. The doctor will give painkillers that must be consumed regularly to relieve the pain experienced.

  • Avoiding strenuous activities

    Strong physical activity, such as lifting heavy weights or exercising, should be avoided in advance to speed up wound healing.

Patients undergoing laparoscopic appendicectomy may experience discomfort in the operated area due to the carbon dioxide gas left behind. However, generally this discomfort will go away after a few days.

Immediately see a doctor if after undergoing appendectomy the patient experiences the following symptoms:

  • Fever or chills
  • Redness, swelling, bleeding, or discharge at the surgical incision site
  • Continuous pain in the surgical wound
  • Vomiting
  • Loss of appetite or unable to eat and drink
  • Continuous cough, difficulty breathing, or shortness of breath
  • Pain, cramping or swelling in the abdomen
  • No bowel movements for 2 days or more
  • Diarrhea for 3 days or more

Although the risk of infection after appendicitis surgery is quite small, usually the doctor will give antibiotics that must be consumed regularly until they run out, in order to prevent the patient from getting an infection.

The process of healing and recovery after appendectomy generally takes 2–6 weeks. During this healing and recovery period, the doctor will schedule regular check-ups for the patient.

Complications of Appendicitis Surgery

Appendectomy is a safe procedure and quite simple to perform. However, just like any other medical procedure, this surgery can still cause complications. Some complications that can occur due to appendectomy are:

  • Hematoma
  • Infection in surgical wound
  • Surgery wound reopens
  • Intestinal obstruction
  • Injury to nearby organs
  • Inflammation and infection of the inside of the abdomen, if the appendix bursts during surgery

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