What is the appendix?
The appendix is a narrow, small, finger-shaped portion of the large intestine that generally hangs down from the lower right side of the abdomen.
If the appendix becomes infected (appendicitis), the infected appendix must be surgically removed (emergency appendectomy) before a hole develops in the appendix and spreads the infection to the entire abdominal space (peritonitis).
What is appendicitis and what causes it?
Appendicitis is a sudden inflammation of the appendix. Although the appendix does not seem to serve any purpose, it can become diseased and, if untreated, can burst, causing infection and even death.
The cause of appendicitis is usually unknown. Appendicitis may occur after a viral infection in the digestive tract or when the tube connecting the large intestine and appendix is blocked or trapped by stool. It is thought that blockage of the opening of the appendix into the bowel by a hard, small stool fragment causes inflammation and infection of the appendix. The inflammation can cause infection, a blood clot, or rupture of the appendix.
The infected appendix then must be surgically removed before a hole develops in the appendix and spreads the infection to the entire abdominal space.
What are the symptoms of appendicitis?
- Abdominal pain -- pain may begin in the upper-middle abdomen then develop to sharp localized pain
- Abdominal pain may be worse when walking or coughing
- Fever usually occurs within several hours
- Loss of appetite
- Rectal tenderness
- Chills and shaking
If you have these symptoms, see a doctor immediately! Because of the risk of rupture, which may happen as soon as 48 to 72 hours after symptoms begin, appendicitis is considered an emergency.
How is appendicitis treated?
The best treatment of appendicitis is its surgical removal. Mild appendicitis may sometimes be cured with antibiotics. More serious cases are treated with surgery to remove the appendix, called an appendectomy. Doctors either use an "open" technique or a minimally invasive approach to remove the appendix.
Appendicitis is considered an emergency and anyone with symptoms needs to see a doctor immediately!
What is a laparoscopic appendectomy?
The laparoscopic (minimally invasive) surgical technique involves making several tiny cuts in the abdomen and inserting a miniature camera and surgical instruments. As many as three or four incisions are made. The surgeon then removes the appendix with the instruments, so there is usually no need to make a large incision in the abdomen. The camera projects a magnified image of the area onto a television monitor which helps guide the surgeons as they remove the appendix.
What is the benefit of laparoscopic appendectomy?
Most cases of acute appendicitis can be treated laparoscopically. The main advantages are:
- Less post-operative pain
- Faster recovery and return to normal activity
- Shorter hospital stay
- Less post-operative complications
- Minimally sized incisions/scars
In most cases, patients can be discharged within 24 to 36 hours. By contrast, the hospital stay is typically two to five days for an open procedure.
Can every patient have a laparoscopic appendectomy?
No. Patients with cardiac diseases and COPD would not be good candidates for laparoscopic appendectomy. In addition, laparoscopic appendectomy is not recommended for those with pre-existing disease conditions.
Laparoscopic appendectomy may also be more difficult in patients who have had previous lower abdominal surgery and for obese patients. The elderly may also be at increased risk for complications with general anesthesia. We evaluate every patient to determine the appropriate type of surgery to perform.
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