Appendicitis refers to the painful and often dangerous inflammation of the appendix. Because appendicitis can result in life-threatening complications — the most likely and alarming of which is rupture — doctors consider the condition a medical emergency. They also take swift and drastic measures to treat the condition, more often than not through the removal of the organ. When an appendix is surgically removed, the procedure is called an “appendectomy.”
The appendix is a little, tube-shaped, finger-shaped pouch that is located on the lower right side of the abdomen and protrudes from large intestine. Like most organs, you cannot really feel its existence — unless, that is, it becomes inflamed. When the appendix becomes inflamed, you will be able to feel it acutely, as appendicitis causes considerable pain.
Though the appendix must have served some evolutionary purpose at some point, scientists are unsure of its exact purpose now. Some research suggests that it holds helpful gut bacteria. However, even if it does do this, no one has ever observed serious consequences for removing it.
Though small, the appendix can cause considerable damage when it becomes inflamed. In fact, its very size is what makes the appendix so dangerous. Because it is so small, the appendix swells quickly and is likely to burst just as fast. When an appendix bursts, it spreads infectious bacteria throughout the abdomen, leading to inflammation of the abdominal lining, or peritonitis. If not managed quickly, the infectious agents can seep into the bloodstream, triggering sepsis in the process. Both sepsis and peritonitis are serious conditions that can cause debilitating symptoms and even death. Because an appendix can burst in as few as 36 hours of initial swelling, it is crucial that you seek a diagnosis and treatment as soon as you develop symptoms of appendicitis.
If you have appendicitis, your doctor is likely to recommend an appendectomy. An appendectomy is a standard surgical procedure that involves removing the appendix when it becomes inflamed. Depending on the severity of the inflammation, your doctor may recommend one of two types of appendectomy.
An open appendectomy is the more invasive of the two types of appendix removal surgeries. When your surgeon performs an open appendectomy, he or she will cut a large incision along the lower right side of your abdomen. He or she will then open the abdominal cavity and separate your abdominal muscles to locate the appendix beneath. If your appendix has already burst, the surgical team will need to drain the abdominal cavity of any fluid or abscess floating around before performing the appendectomy. Once the fluid is gone, the team will use a saline solution to thoroughly cleanse the cavity before proceeding with the procedure. Draining and cleansing the cavity is necessary to prevent further infection.
If your surgical team determines that you are a candidate for a laparoscopic appendectomy, it will make a small incision near the belly button. It will then insert a tiny port into the incision and, through the port, insert a tube called a cannula. The cannula’s job is to inflate the abdominal cavity with carbon dioxide gas to both make the contents of the cavity more visible and to make more room for the operation.
Once the cannula’s job is complete, the team will remove it and replace it with a laparoscope, which is essentially a long, thin tube with a camera at the end. The surgeon will use the images from the camera to guide the appendectomy, which he or she will perform with small instruments he or she inserts through two to three other tiny incisions.
In both an open and laparoscopic appendectomy, the surgeon first ties off the appendix with stitches then carefully removes it from the colon. He or she will also drain the abdominal cavity of excess fluids, gas or abscesses. If you developed peritonitis, the surgeon may keep the drainage tube attached to your abdomen until all the fluid is gone.
Though open and laparoscopic appendectomies accomplish the same goals — removing the appendix and cleansing the abdominal cavity — not everyone qualifies for both. In ideal situations, your surgical team can accomplish these goals with a laparoscopic appendectomy, as it is less invasive. However, some situations may necessitate the more invasive open appendectomy.
One situation in which an open appendectomy may be necessary is if your surgeon detects complications through the laparoscope’s images. It is easier and more efficient for surgical teams to deal with complications via an open appendectomy than a closed.
Another situation in which an open appendectomy may be necessary is if the appendix has already burst. As with complications, a burst appendix is easier to deal with via an open incision than a tiny one.
Though both types of surgeries come with a low risk of complications, a laparoscopic appendectomy is preferred as it requires a shorter recovery time. Additionally, it comes with a lower risk of pain and scarring both during and after the procedure.
Appendectomies are not new procedures. In fact, they have been the standard way of dealing with appendicitis for more than 120 years. Each year, approximately 300,000 appendectomies are performed.
Time and again, case studies reveal that removing the appendix has no real or long-term complications for patients. This is likely because the appendix has no discernible function. That said, immediately following an appendectomy, you may experience a few minor complications:
These side effects should disappear within a few days to a couple weeks post-surgery.
Most appendectomies go smoothly and without any follow-up complications. That said, in rare situations, complications can develop. Complications of appendectomies may include the following:
Recovering from an open appendectomy typically requires the same time and care as recovering from any other surgery. For most people, the pain and side effects begin to wane after a couple of days and disappear within a few weeks. Doctors recommend that patients wait several weeks before returning to normal activity levels, with six weeks being the maximum recovery time for most individuals.
You can help speed up your recovery by following a few tips for what and what not to do following an appendectomy.
An open appendectomy is a standard and typically uneventful procedure. If your doctor does recommend an open appendectomy instead of a laparoscopic one, know that the recommendation comes only in your best interests.