Laparoscopic Appendectomy

What is Laparoscopic Appendectomy

Laparoscopic appendectomy is a surgery to take out the appendix. The appendix is a finger-like structure that is attached to the large intestine.

In this surgery, the appendix is removed through two or three small cuts (incisions) with the help of a thin, lighted tube that has a tiny camera on the end (laparoscope).

A laparoscopic appendectomy may be done to prevent an inflamed appendix from bursting (rupturing). Or, it may be done to treat the infection from an appendix that has already ruptured. It is usually done immediately after inflammation of the appendix (appendicitis) is diagnosed.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

When is laparoscopic appendectomy appropriate? 

Laparoscopic appendectomy was first reported in 1983, and its use has increased steadily since.

Although a bias may exist toward the use of laparoscopy with less advanced appendicitis, mortality and length of stay are similar or improved. Cosmesis, postoperative pain, and wound infection rates are also improved.

Although initial studies in the 1990s expressed concern about increased intraabdominal abscess formation, more recent data has shown no differences.

In the ever-rising obese population, laparoscopy has shown decreased rates of morbidity overall compared with the open technique.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding.
  • Allergic reactions to medicines.
  • Damage to other structures or organs.
  • The formation of collections of pus (abscesses).
  • Long-lasting pain or scarring at the incision sites or inside the abdomen.
  • Blood clots in the legs.

What happens before the procedure?

  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
  • Ask your health care provider how your surgical site will be marked or identified.
  • You may be given antibiotic medicine to help prevent infection or to treat existing inflammation or infection.
  • If you will be going home on the same day as your surgery, plan to have someone with you for 24 hours.

What happens during the procedure?

  • To reduce your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
  • An IV tube will be inserted into one of your veins. You will receive medicine and fluids through this tube.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
    • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
    • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
  • A thin, flexible tube (catheter) may be put into your bladder to drain urine.
  • A tube may be passed through your nose and into your stomach (NG tube, or nasogastric tube) to drain any stomach contents.
  • Your surgeon will make two or three small incisions near your belly button (navel).
  • Air-like gas will be used to fill your abdomen. The gas will make your abdomen expand. This helps the surgeon to see clearly and gives him or her more room to work.
  • A laparoscope will be passed through one of the incisions.
  • Other long, thin surgical instruments will be passed through the other incisions.
  • The appendix will be located and removed through one of the incisions.
  • The abdomen may be washed out to remove bacteria.
  • The incisions will be closed with stitches (sutures), staples, or adhesive strips.
  • A bandage (dressing) may be used to cover the incisions.
  • If a tube was inserted into your bladder or stomach, it will be removed.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
  • You will be given pain medicine as needed to keep you comfortable.
  • If your appendix did not rupture, you may be able to go home the same day as your surgery.
  • Do not drive for 24 hours if you received a sedative.
  • If your appendix ruptured:
    • You will get antibiotic medicine through an IV tube.
    • You may be sent home with a temporary drain.

Care After Laparoscopic Appendectomy

These instructions give you information about caring for yourself after your procedure. Your doctor may also give you more specific instructions. Call your doctor if you have any problems or questions after your procedure.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your doctor.
  • Do not drive for 24 hours if you received a sedative.
  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • If you were prescribed an antibiotic medicine, take it as told by your doctor. Do not stop taking it even if you start to feel better.

Activity

  • Do not lift anything that is heavier than 10 pounds (4.5 kg) for 3 weeks or as told by your doctor.
  • Do not play contact sports for 3 weeks or as told by your doctor.
  • Slowly return to your normal activities.

Bathing

  • Keep your cuts from surgery (incisions) clean and dry.
    • Gently wash the cuts with soap and water.
    • Rinse the cuts with water until the soap is gone.
    • Pat the cuts dry with a clean towel. Do not rub the cuts.
  • You may take showers after 48 hours.
  • Do not take baths, swim, or use a hot tub for 2 weeks or as told by your doctor.

Cut Care

  • Follow instructions from your doctor about how to take care of your cuts. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If you do not have soap and water, use hand sanitizer.
    • Change your bandage as told by your doctor.
    • Leave stitches (sutures), skin glue, or skin tape (adhesive) strips in place. They may need to stay in place for 2 weeks or longer. If tape strips get loose and curl up, you may trim the loose edges. Do not remove tape strips completely unless your doctor says it is okay.
  • Check your cuts every day for signs of infection. Check for:
    • More redness, swelling, or pain.
    • More fluid or blood.
    • Warmth.
    • Pus or a bad smell.

Other Instructions

  • If you were sent home with a drain, follow instructions from your doctor about how to use it and care for it.
  • Take deep breaths. This helps to keep your lungs from getting swollen (inflamed).
  • To help with constipation:
    • Drink plenty of fluids.
    • Eat plenty of fruits and vegetables.
  • Keep all follow-up visits as told by your doctor. This is important.

Contact a doctor if:

  • You have more redness, swelling, or pain around a cut from surgery.
  • You have more fluid or blood coming from a cut.
  • Your cut feels warm to the touch.
  • You have pus or a bad smell coming from a cut or a bandage.
  • The edges of a cut break open after the stitches have been taken out.
  • You have pain in your shoulders that gets worse.
  • You feel dizzy or you pass out (faint).
  • You have shortness of breath.
  • You keep feeling sick to your stomach (nauseous).
  • You keep throwing up (vomiting).
  • You get diarrhea or you cannot control your poop.
  • You lose your appetite.
  • You have swelling or pain in your legs.

Get help right away if:

  • You have a fever.
  • You get a rash.
  • You have trouble breathing.
  • You have sharp pains in your chest.
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