APPENDECTOMY

Summary

The appendix is a small pouch located on the lower right side of your abdomen, attached to the end of the large intestine. It is unknown what role the appendix plays in the body, but occasionally it may become infected with mucus, bacteria and stool. This irritation and inflammation of the appendix are known as appendicitis. 

Acute appendicitis is the most common condition of the abdomen to require emergency surgery. Because of the likelihood of the appendix rupturing and causing a severe, life-threatening infection known as peritonitis, the usual recommendation is that the appendix is removed as soon as possible, to prevent the appendix from perforating.

An appendectomy is a common surgery done to remove the appendix in such cases. Because of the risk of rupture, which may occur as soon as 48 to 72 hours after symptoms begin, appendicitis is considered an emergency and anyone with symptoms needs to see a doctor immediately.

The procedure is performed to treat appendicitis, to prevent rupturing or treat a ruptured appendix. Since the appendix plays no key role in the body, it is possible to live without one, and most people recover quickly and without complications.

Reasons for an appendectomy

  • Treatment of appendicitis
  • To prevent rupturing of the appendix

How to tell if you have appendicitis

Symptoms of appendicitis include pain in the abdomen, in the lower right-hand side of the abdomen or around the belly button that seems to be worsening. Nausea, vomiting, loss of appetite, fever and chills, constipation, diarrhoea, inability to pass gas, and abdominal swelling may also be present.

The symptoms of appendicitis may resemble other medical conditions or problems. In addition, each individual may experience symptoms differently. It is important that people with symptoms of appendicitis not take laxatives or enemas to relieve constipation, as these medications and procedures can cause the appendix to burst. In addition, the pain medication should be avoided, as this can mask other symptoms.

Types

1Laparoscopic appendectomy
A laparoscopic appendectomy is carried out under general anaesthetic, so you will not feel any pain during the procedure.

During the surgery, your surgeon will make one or more small incisions in the abdomen near the appendix. These incisions will allow your surgeon to insert the laparoscope and small surgical tools into the abdomen. Carbon dioxide gas will be introduced into the abdomen through a tube to inflate the abdominal cavity to make it easier for the surgeon to look around and operate. The appendix is then located, tied off with sutures and removed. After the procedure, the gas is let out of your abdomen, the incisions are closed using stitches, and a dressing is applied.

Benefits of this approach

Laparoscopy is a type of surgical procedure that allows a surgeon to access the inside of the abdomen (tummy) and pelvis without having to make large incisions in the skin. This procedure is also known as keyhole surgery or minimally invasive surgery.

Large incisions can be avoided during laparoscopy because the surgeon uses an instrument called a laparoscope. This is a small tube that has a light source and a camera, which relays images of the inside of the abdomen or pelvis to a television monitor.

The advantages of this technique over traditional open surgery include:

  • shorter hospital stay and faster recovery time
  • less pain and bleeding after the operation
  • reduced scarring
2Open appendectomy
In most cases, Dr Kavin chooses to perform an appendectomy through minimally invasive techniques; however, if the appendix has already burst, open surgery is needed so that the area can be cleaned out properly.

During open surgery, one large incision is made in the lower right side of your abdomen. The appendix is accessed and removed and tied off with stitches. Thereafter the abdominal cavity is cleaned before closing the incision with stitches.

Risks

Laparoscopic surgery is very common and generally regarded as safe. Serious complications are rare, occurring in just one in 1,000 cases, according to estimates.

Possible complications include:

  • damage to organs, such as the bladder or bowel
  • injury to a major artery
  • damage to nerves in the pelvis

As with any surgical procedure, complications may occur. Some possible complications include, but are not limited to, the following:

  • Wound infection
  • Peritonitis - Inflammation of the abdomen that can occur if the appendix ruptures during surgery
  • Bowel obstruction

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Hospital

Operating from the new state-of-the-art, multi-disciplinary facility equipped with only the most advanced medical technology,

Equipment

As one of only two such robots in the Western Cape, Dr Kavin operates from a hospital boasting Robotic Surgery capabilities,

Technique

As a surgeon with adept skill in minimally invasive techniques, Dr Kavin opts for laparoscopic keyhole surgery whenever possible.

Expertise

Dr Bruce Kavin is a General Surgeon with particular expertise in Endocrine, Colorectal and Gastrointestinal Surgery and Surgical Oncology.

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