Surgery for Appendicitis
Your side may hurt so much that you call your healthcare provider. Or maybe you go straight to the hospital emergency room. After your evaluation, your healthcare provider may decide that you have appendicitis. If so, you will need surgery. Your healthcare provider will send you to a hospital room or take you right to the operating room. There, your medical team will prepare you for surgery.
You may receive fluids and antibiotics through an IV (intravenous) line. Tell your healthcare provider if you are allergic to any antibiotics or other medicines. Before surgery, an anesthesiologist or nurse anesthetist will also talk to you. He or she will give you general anesthesia just before your appendectomy. This keeps you pain-free and allows you to sleep during the surgery.
The goal of surgery is to remove your appendix safely. In most cases, the surgery lasts from 30 minutes to an hour. If your appendix has burst or perforated releasing bacteria into the abdominal cavity, surgery may take longer. Your surgeon may use 1 of 2 techniques to reach your appendix. Your surgeon will discuss which is best for you:
Open surgery. Your surgeon makes 1 incision (several inches long) in your lower right side. He or she makes a bigger incision if your appendix has perforated.
Laparoscopic surgery. Your surgeon makes from 2 to 4 small incisions. One is near your bellybutton. The others are elsewhere on your stomach. Your surgeon inserts a laparoscope, a thin tube with a camera attached, through one of the incisions. The camera shows the inside of your belly on a monitor. This image helps guide the surgery. Your surgeon inserts surgical tools into the other incisions.
Sometimes if the appendix has burst and a pocket of infection has formed, this will be drained and antibiotics given for some time (perhaps weeks) before the appendix is removed.
Finishing the surgery
In most cases, the surgeon closes the entire incision with stitches or staples. Your surgeon may place a temporary drain in the wound or in your belly. This helps cure or prevent infection. If your appendix perforated, your surgeons may leave the outer layers of your incision open. Leaving the skin open prevents infection from forming under the skin. It may heal on its own, or be closed about 5 days later.
Most patients recover quickly after an appendectomy. You will likely be in the hospital for 1 to 2 days. If your appendix perforated, you may stay longer. After you return home, plan on a follow-up visit to the healthcare provider in 1 to 2 weeks.
In the hospital
In most cases, you will drink liquids and walk on the day of your surgery. You will also receive pain medicine. To help keep your lungs clear, a healthcare provider may teach you how to do breathing exercises.
Back at home
To help control pain from surgery, take your medicines as directed. Avoid strenuous activity, heavy lifting, and driving until your surgeon says it is OK. As instructed, slowly resume your normal activities in 7 to 10 days.
Risks and complications
Risks and complications can include the following:
Infection or bleeding from the incision site
Infection or swelling in the belly, or leakage of bowel material
Delayed return of bowel or intestinal function (bowel ileus) or bowel blockage
Problems from anesthesia
Call your healthcare provider
Call your healthcare provider if you notice any of the following:
Swelling, oozing, worsening pain, or unusual redness around the incision
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
Worsening belly pain
Severe diarrhea, bloating, or constipation
Nausea or vomiting
March 21, 2017
Abdominal access techniques used in laparoscopic surgery. UpToDate, Acute Appendicitis — Appendectomy or the “Antibiotics First” Strategy. Flum D. New England Journal of Medicine. 2015;(372)20:1937-43., Management of Acute Appendicitis in Adults. UpToDate
Freeborn, Donna, PhD, CNM, FNP,Lehrer, Jenifer, MD