Located on the lower right quadrant of abdomen, the appendix is a finger-like pouch or a worm-like appendage present at the ileocecal junction, which is the place where the ileum from the small intestine and the cecum from the colon come together. Though it doesn't play any role in the digestive process, it is believed that it plays an immunological role.
Problems arise when it becomes obstructed by hardened stool pr mucus that cause bacteria to multiply, thereby resulting in appendicitis (inflammation of the appendix). This condition could also occur due to inflammatory bowel disease, gastrointestinal infection, or trauma to the abdomen. Its symptoms include pain that is first experienced around the navel and then shifts to the lower right abdomen, tenderness, nausea, vomiting, loss of appetite, low-grade fever, constipation, diarrhea, abdominal swelling, etc. Acute appendicitis is considered to be a medical emergency, and it must be treated to avert the rupturing of the inflamed appendix. The surgical removal of the appendix is medically referred to as appendectomy.
Surgical Removal of Appendix
An inflamed appendix can even burst in the absence of prompt treatment, and could prove to be fatal. Therefore, appendix removal becomes important. The aim of this surgery is to prevent the complications associated with the rupturing of the inflamed appendix. The removal of the inflamed appendix could be performed using open surgery or laparoscopic surgery. Doctors generally evaluate the patient's condition to decide which type of surgery should be performed. Both these procedures are performed under general anesthesia.
Traditional open surgery is performed by making an incision in the lower right section of the abdomen. The surgeon then pulls the appendix through the incision and removes it. The cecum is then closed and the incision is sutured. If the appendix has ruptured, then the pus is cleaned using a warm saline solution or drained out from the abdomen. The incision is not sutured till the pus has been drained out completely. Once the pus has been drained, the skin and muscle layers are sewn together.
Laparoscopic removal is a minimally invasive technique. Under this procedure, a small incision is made right below the navel and a laparoscope is inserted. A laparoscope is a long tube which has a lens at one end and a miniature video camera at the other. It is attached to a monitor, which is used by the surgeon to get a magnified view of the operative field to examine the condition of the appendix and the surrounding organs. A few tiny incisions are made and the special instruments are then passed through the small incisions, and the removal is performed. The abdominal cavity is inflated with carbon dioxide. The appendix is then removed through one of the incisions. The cecum is stitched and all the incisions are sutured.
As with any other surgery, there are certain risks involved in appendectomy as well. Risks involved would depend on the state of the appendix at the time of its removal. If the appendix ruptures during the surgery, pus might spill over the abdominal cavity. This can cause peritonitis or a generalized infection in the abdomen. Other complications include injury to the surrounding organs, bleeding, infection at the site of incision, formation of abscesses, etc. Paralytic ileus is another complication that may arise after the surgery. It occurs when the bowel movement gets disturbed and comes to a standstill. The bowel might become swollen or distended due to fluid and gas.
Though laparoscopic surgery has certain advantages such as less post-operative pain, shorter stay at the hospital, less scarring and shorter recovery time, this surgical procedure may be difficult in case of patients who have undergone an abdominal surgery. Intra-abdominal abscesses and perforation of the bowel are some of the other risks. Complications could arise due to the longer exposure to anesthetics.
Those who have undergone an appendectomy must take proper care for faster recovery. If symptoms such as rectal bleeding, increased abdominal swelling, shortness of breath, pus or redness around the incisions, persistent fever, and an inability to eat and drink are experienced post surgery, one must consult a doctor immediately.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.