Appendix removal

What is the appendix

The appendix is a blind-ended tube connected to the cecum which is a pouch-like structure at the beginning of the large intestine. Appendicitis is a condition characterized by the inflammation of the appendix which is removed during surgery.

Who should undergo the surgery

Appendix removal surgery is most commonly performed as a laparoscopic procedure in patients who suffer from acute appendicitis. It is an emergency, life-saving surgery. Untreated or poorly treated acute appendicitis may very often lead to the death of the patient. Some patients suffer from long-term chronic appendicitis. In these cases, with the main symptom being pain in the right lower part of the abdomen, appendix removal is indicated after having performed gastroenterological and/or gynecological examination.

Before the procedure

As a first step, you will undergo surgical examination of the abdomen. The physician will evaluate the results of imaging tests performed (e.g. ultrasound, abdominal CT) and possibly other examinations (colonoscopy, gynecological examination). If appendicitis is confirmed you will be explained the surgical procedure and anesthesia and informed about any possible risks by the physician. You may ask any questions, in particular, questions related to the procedure, your expectations and concerns, during the discussion.

At the same time, you will be provided with an information sheet on how to prepare for the surgery, including information on eating, drinking, smoking and taking or discontinuing some medicines, which will be explained to you. Complying with all the recommendations is necessary for the surgery to run smoothly and for event-free healing.

How is the procedure performed

The procedure is performed laparoscopically. During the procedure, the abdominal cavity is filled with carbon dioxide in order to create and maintain a distended abdomen with separated abdominal structures to have room for operation. Three small wounds (0.5-1 cm) remain after the incisions made for the procedure in the area of the navel and in two other areas (above the pubic symphysis and in the left hypogastrium).

The appendix is removed, put into a protective bag which is then removed from the abdominal cavity. Sometimes, it is advisable to put a drain into the area from which the appendix was removed, i.e. to the wall of the large intestine.

After the surgery

In the hours immediately after surgery, you may feel pain in the surgical site(s). This pain is completely natural and it will be reduced by means of pain-killers. After discharge, you will use drugs to treat pain that your treating physician will prescribe to you. You should be pain-free within 24-48 hours. Long-term pain is usually an indication of a complication and, therefore, you should contact your treating physician in this case. Sometimes, vomiting occurs which is an adverse effect of anesthesia, in particular general anesthesia, and it usually subsides within 6-12 hours after surgery. You may start walking within a few hours of surgery. You should avoid physical stress for 3 weeks after surgery (including sports and more demanding leisure activities), comply with diet restrictions for several days after which the patient starts eating normally. It is not recommended to bathe, either in a bathtub or in indoor and outdoor swimming pools until surgical wounds are healed. It is more appropriate to take a shower. The sick leave is 2-4 weeks in average depending on the profession.