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Parker Lopez
Parker Lopez

Appendectomy



Both types of surgery have low risk of complications. A laparoscopic appendectomy has a shorter hospital stay, shorter recovery time, and lower infection rates.Recently, some studies have suggested that intravenous antibiotics alone could cure appendicitis without the need for appendectomy. These results remain controversial and appendectomy remains the standard of care.




appendectomy



Appendectomy is a common surgery and many people have had their appendix removed. One way to remove the appendix is by making one larger cut, or incision, below and to the right of your belly button. This is referred to as an open appendectomy.


You will have general anesthesia for your laparoscopic appendectomy. This means that you are asleep during surgery. When surgery is finished, the surgeon closes your incisions with tiny stitches, staples, surgical tape or glue.


Complications of laparoscopic appendectomy do not happen often. They can include bleeding, infection in the surgery area, hernias, blood clots, and heart problems. A hernia is a hole that allows a small amount of your gut (intestine) or other tissue to bulge through the muscles that cover it.


Appendectomy, the removal of the small pouch attached to the beginning of your large intestine when you have an acute bout of appendicitis is one of the most common emergency abdominal surgeries. The appendix is a small, finger-shaped organ that comes out of the first part of the large intestine. It needs to be removed when it becomes swollen or infected. If the appendix is not removed, it can leak bacteria and infect your entire belly, which can be very life threatening. So, what are the signs that you have appendicitis? Well, this condition can be fairly hard to diagnose, especially in children, older people, and women of childbearing age. Usually, the first symptom is pain around your belly button. The pain might be mild at first, but then it gets sharp and severe before not too long. The pain may then move into your right lower abdomen. You may also have diarrhea, fever, nausea, and a reduced appetite. Sometimes, people think that they might be having food poisoning. Your doctor will make a diagnosis based on your symptoms. You may also have blood tests and a CT scan or ultrasound. Once it's clear that you have appendicitis, your doctor will probably schedule you for emergency surgery. In surgery, you will receive anesthesia and be asleep and pain free. The doctor will make a small cut in the lower right side of your belly and remove your appendix. If the surgeon uses the laparoscopic technique, you will have several small cuts in your abdomen for the surgical instruments. If your appendix broke open, or a pocket of infection has formed, your doctor will wash out your belly during the surgery. A small tube may remain to help drain out fluids or pus. Once you've had an appendectomy, you will probably recover pretty quickly. It feels good to get a bad appendix out. Most patients leave the hospital 1 to 2 days after surgery. The good news is that you'll be able to go back to all those normal activities within 2 to 4 weeks.


An appendectomy, also termed appendicectomy, is a surgical operation in which the vermiform appendix (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acute appendicitis.[1]


The standardization of an incision is not best practice when performing an appendectomy given that the appendix is a mobile organ.[8] A physical exam should be performed prior to the operation and the incision should be chosen based on the point of maximal tenderness to palpation.[8]


Pediatric patients have a mobile cecum, which allows externalization of the cecal appendix through the umbilicus in most cases. This has led to the development of surgical techniques such as laparoscopic-assisted transumbilical appendectomy, which allows the entire surgery to be performed with a single umbilical incision and has significant advantages in terms of both recovery and aesthetic outcome. [12]


Appendicitis is the most common emergent general surgery related problem to arise during pregnancy. There is a natural elevation in white blood cell count in addition to anatomical changes of the appendix that occur during pregnancy.[13] These findings, in addition to non-specific abdominal symptoms make appendicitis difficult to diagnose. Appendicitis develops most commonly in the second trimester.[2] If appendicitis develops in a pregnant woman, an appendectomy is usually performed and should not harm the fetus.[14] The risk of premature delivery is about 10%.[15] The risk of fetal death in the perioperative period after an appendectomy for early acute appendicitis is 3 to 5%. The risk of fetal death is 20% in perforated appendicitis.[16]


One of the most common post-operative complications associated with an appendectomy is the development of a surgical site infection (SSI).[19] Signs and symptoms indicative of a superficial SSI are redness, swelling, and tenderness surrounding the incision and are most likely to arise on post-operative day 4 or 5. These symptoms oftentimes precede fluid drainage from the incision. Tenderness extending beyond the redness that surrounds the incision, in addition to the development of cutaneous vesicles or bullae may be indicative of a deep SSI.[19]


The first recorded successful appendectomy was performed in September 1731 by English surgeon William Cookesley on Abraham Pike, a chimney sweep.[22][23] The second was on December 6, 1735, at St. George's Hospital in London, when French surgeon Claudius Amyand described the presence of a perforated appendix within the inguinal hernial sac of an 11-year-old boy.[7] The organ had apparently been perforated by a pin the boy had swallowed. The patient, Hanvil Andersen, made a recovery and was discharged a month later.[24]


Harry Hancock performed the first abdominal surgery for appendicitis in 1848, but he did not remove the appendix.[25] In 1889 in New York City, Charles McBurney described the presentation and pathogenesis of appendicitis accurately and developed the teaching that an early appendectomy was the best treatment to avoid perforation and peritonitis.


While appendectomy is a standard surgical procedure, its cost has been found to vary considerably in the United States. A 2012 study analyzed 2009 data from nearly 20,000 adult patients treated for appendicitis in California hospitals. Researchers examined "only uncomplicated episodes of acute appendicitis" that involved "visits for patients 18 to 59 years old with hospitalization that lasted fewer than four days with routine discharges to home." The lowest charge for removal of an appendix was $1,529 and the highest $182,955, almost 120 times greater. The median charge was $33,611.[30][31] While the study was limited to California, the researchers indicated that the results were applicable anywhere in the United States. Many, but not all, patients are covered by some sort of medical insurance.[32]


Laparoscopic appendectomy: Most of the time, surgeons remove the appendix with the help of a tiny video camera called a laparoscope. It lets them see inside the body while looking at a special TV monitor. The surgeon makes a small incision (cut) in the belly button and inserts the thin tube of the laparoscope. The laparoscope acts as the surgeon's "eyes" as it is guided to the appendix. The surgeon may make two more small incisions for the medical instruments. Using the instruments, the surgeon carefully cuts the appendix away from the large intestine and removes it. The incisions are closed with dissolvable stitches and covered with small bandages.


Open appendectomy: This is the "traditional" way of removing the appendix. The surgeon makes an incision (cut) in the belly, then carefully cuts the infected appendix away from the large intestine and removes it. The surgeon closes the incision with stitches.


After an appendectomy, most kids stay in the hospital for less than a day. Kids at higher risk for infection may need to stay longer to get IV antibiotics. This is typical for kids whose appendix ruptures (bursts) before the appendectomy.


Not necessarily. In the U.S. today, laparoscopic appendectomy is more common than the traditional open appendectomy. Laparoscopic surgery offers a less-invasive alternative to open abdominal surgery by using several micro-incisions instead of one larger incision. Laparoscopic appendectomy is associated with less pain and faster recovery time. The type of appendectomy you receive may depend on your condition as well as the training and judgment of your surgeon.


For an open appendectomy, your surgeon will make one larger incision in your lower right abdomen. They will open the abdominal cavity and separate your abdominal muscles to locate the appendix beneath. If your appendix has ruptured, there may be an abscess or fluid in the abdominal cavity to drain before they can perform the appendectomy. Then they will rinse the abdominal cavity with a saline solution.


An appendectomy is the surgical removal of the appendix, which is located in the right lower side of the abdomen. This operation is usually carried out on an emergency basis to treat appendicitis (inflamed appendix). This may occur as a result of an obstruction in part of the appendix. Another name for this operation is an appendicectomy. Some common symptoms of appendicitis are nausea, vomiting, constipation and pain. The pain is initially felt in the centre of the abdomen and later moves to become a sharper pain in the right lower abdomen. The area is tender to the touch. Occasionally, some of these symptoms may be absent and it becomes necessary to investigate the abdominal cavity to make a diagnosis.


The type of operation you have will depend on how severe your appendicitis is. The surgeon will discuss your options with you. If there is anything you want to know or are not clear about, it is important to ask your doctor or surgeon to explain it in terms you can understand. A laparoscopic appendectomy may need to become open surgery if the appendix has ruptured. Once the appendix is accessed by either open or laparoscopic surgery, the blood vessels that supply it are clamped and the appendix is cut and removed. In laparoscopic appendectomy, the appendix is removed through one of the small 'keyhole' incisions. 041b061a72


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