Appendicitis Surgery, Here's What You Should Know

Appendectomy or appendectomyektomiis surgery to remove the appendix or appendix (appendix) who have been infected (appendicitis). The appendix is ​​a sac-shaped organ small which stick outfrom colon.

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

Appendectomy can be performed using two techniques:

Open appendectomy

An 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.

An open appendectomy is generally performed when the patient's appendix has ruptured and the infection has spread. An open appendectomy is also 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 inflammation of the appendix that does not improve with medication. If not treated promptly, 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 the stomach
  • Stiff abdominal muscles
  • Diarrhea
  • Constipation or constipation
  • Mild fever
  • Loss of appetite
  • Hard to fart
  • Nausea and vomiting

Appendix Surgery Warning

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

  • Are you pregnant in the first trimester?
  • Experiencing a ruptured appendix
  • Have thick fat in the stomach, because the appendix will be difficult to see
  • Having intestinal adhesions
  • Are undergoing immunosuppressant therapy or radiotherapy
  • Have a blood clotting disorder (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 An appendectomy

Before an appendectomy is performed, tell your doctor if you:

  • Is pregnant
  • Have an allergy to latex or anesthetics
  • Are taking certain medications, including herbal products and supplements
  • Suffering from other diseases
  • Have a history of bleeding
  • Are undergoing a therapy or medication

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 needed, the doctor will also perform laboratory tests, such as blood tests and scans.

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

  • Remove jewelry and other items that may interfere with the operation
  • Changing clothes into hospital clothes
  • Shave the hair in the area to be operated on

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

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

Procedure An appendectomy

As explained earlier, appendectomy can be performed in two ways, namely open appendectomy and laparoscopic appendectomy. The following are the stages of performing 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 using surgical thread, then cut.
  • If the appendix has ruptured, the stomach will be washed using salt water (saline).
  • Rinse water, blood, and other body fluids around the operated area will be removed using a special suction device.
  • After the operation, the abdominal muscles and skin incisions will be sutured, then covered with a bandage to prevent infection.
  • The excised appendix will be sent to a laboratory for analysis.

Slightly different from an 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 an 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.
  • A laparoscope is inserted through the incision to locate 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 abdomen. Carbon dioxide gas will come out through the incision hole.
  • After the operation, 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 a 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 complete, the patient will be transferred to the recovery room. Patients will also receive further medical treatment as follows:

  • Monitoring physical conditions, such as respiratory rate, heart rate, and blood pressure
  • Giving pain relievers, either in the form of oral drugs or injections
  • Insertion of a tube from the nose to the stomach to remove water and air in the stomach if necessary

The patient can drink water a few hours after appendectomy and gradually eat solid food if his physical condition improves.

Patients who underwent laparoscopic appendicectomy were allowed to get out of bed a few hours after surgery, while patients who underwent open appendicectomy were only allowed to get out of bed a few days after surgery.

Most patients are able to 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:

  • Menjaga wound stitching always dry and clean

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

  • Use pain relievers as directed

    Surgical incisions can be painful, especially after standing for a long time. The doctor will give you painkillers that must be consumed regularly to relieve the pain experienced.

  • Avoid strenuous activity

    Strenuous physical activity, such as lifting heavy weights or exercising, should be avoided beforehand in order to speed healing of the surgical wound.

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
  • Ongoing pain at the surgical site
  • Throw up
  • Loss of appetite or unable to eat and drink
  • Persistent cough, difficulty breathing, or shortness of breath
  • Pain, cramping, or swelling in the abdomen
  • Not defecating for 2 days or more
  • Diarrhea for 3 days or more

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

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

Complications An appendectomy

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

  • Hematoma
  • Infection in the surgical wound
  • The surgical wound is open again
  • Intestinal blockage
  • Injury to nearby organs
  • Inflammation and infection of the inside of the abdomen, if the appendix ruptures during surgery