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Laparoscopic Appendectomy Surgery
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You May Have These Symptoms
- Elevated temperature
- Severe abdominal pain followed by nausea or vomiting
- Pain in right lower abdomen
- Constipation
- Diarrhea
- Elevated white blood count
[back to top]What is Appendicitis?
You may be asked to consider undergoing a surgical procedure for appendicitis. The appendix is part of your intestine, is hollowed, and is attached to your large bowel. Appendicitis is the inflammation of the appendix. Appendicitis is more common is males than in females.
What are Treatment Options?
Traditional Approach
You are given general anesthesia. A two inches or larger incision is made in the skin located in the right lower abdomen. You will experience pain and expect to stay in the hospital for 2 to 5 days. You will be able to return to work in 4 to 6 weeks.
Laparoscopic Appendectomy
Your physician may recommend laparoscopic appendectomy surgery. With recent advances, the technique has been modified using a laparoscopic (advanced minimally invasive) approach that avoids the need for a large incision. There can be significantly decreased pain in some patients. In laparoscopic appendectomy surgery, the patient is also given general anesthesia. As many as three or four small incisions are made. One is used for the laparoscope which is attached to a camera that sends images to a video monitor. The other incisions are used to hold or manipulate tissue in the abdomen. Carbon dioxide gas is inflated into the abdominal cavity to allow room to work and allow the surgeon to see. The appendix is identified and carefully dissected and removed. Your surgeon may use staples, clips or sutures. At the end of the surgery, carbon dioxide gas is removed.
What can I Expect to Happen Before Having Laparoscopic Appendectomy Surgery?
- Preoperative tests may be ordered depending upon your medical condition and the type of anesthesia planned for your surgery.
- The surgery is usually performed in an emergency basis.
- Blood tests, electrocardiogram (EKG) or chest x-ray may be ordered.
- Ask for extra help at home after surgery.
What are Expected Results After Having Laparoscopic Appendectomy Surgery Versus Having an Open Abdominal Surgery?
- Decreased postoperative pain
- Shortened hospital stay
- More rapid return to bowel function
- More rapid return to work
- Minimally sized incisions with a better cosmetic result
What are the Risks of Having Laparoscopic Appendectomy Surgery?
As with any surgery there are risks. The risk of one of these complications is no greater than if the surgery were done with the open technique. Complications that can occur are:
- Bleeding
- Infection involving the wound, blood or abdomen
- Injury to surrounding organs such as the bladder, intestines, blood vessels, or nerves
- Difficulty urinating following surgery may occur and a temporary catheter may be ordered to drain the bladder
What Happens if Surgery Cannot be Performed by Laparoscopic Technique?
Sometimes it is not possible for the surgeon to use the laparoscopic technique because it may be difficult to see or handle tissue safely. The surgeon decides to perform an open procedure either before or during the surgery. The surgeon may decide to convert the laparoscopic surgery to an open procedure in certain situations and for patient safety. Though very infrequent, when conversion to an open technique occurs, it should not be considered a failure of the procedure. Factors that might increase the possibility of changing to an "open" procedure are obesity, previous abdominal surgery causing dense scar tissue, inability to see organs or bleeding during surgery.
What can I Expect to Happen Before Having Laparoscopic Surgery?
- A thorough medical evaluation will be made by your physician. Several diagnostic tests may be needed. You may have blood tests, an electrocardiogram (ECG or EKG) or chest x-ray to check your heart and lungs. You and your physician will discuss whether or not this surgery will help you.
- Taking no food or liquids before the surgery. This decreases the risk of vomiting after you receive anesthesia.
- You must inform your physician all the medications that you take, especially if you take blood thinners.
- Speak with the anesthesiologist before surgery to discuss anesthesia and keeping you free of pain during surgery and pain management postoperatively.
What can I Expect the Day of Surgery?
- You will probably be admitted to the hospital in an urgent basis.
- Sign a written consent authorizing your physician to perform surgery.
- Receive a small needle/catheter in your vein to provide medication before, during and after your surgery.
- Receive preoperative medications as necessary.
- Going to the recovery room after surgery and having your blood pressure, pulse, and respirations closely monitored until you are fully awake.
- Receive medication to relieve discomfort.
- Receive small bandages over incisions.
What can I Expect After Surgery?
- Incision sites will be tender. Take pain medication as directed.
- You make take a shower two days after surgery.
- You may experience bloating or constipation. Resume a healthy, high-fiber diet as soon as you go home.
- Lift objects that are easy to handle. Use your legs to handle most of the work. Avoid strenuous activity.
- Walking and stair climbing are good to improve your circulation.
- Avoid driving for seven days after your surgery and when taking pain medication.
- Assume sexual intercourse as soon as you feel comfortable and have discussed this with your surgeon.
- Call and schedule a follow-up appointment within one to two weeks after surgery. Schedule any additional follow-up appointments.
- Have any stitches removed depending upon the type your physician uses.
- Discuss with your surgeon your return to an office job within 2 weeks and up to 4 weeks for physically demanding jobs.
When Should I Call My Physician?
Make certain that you call your physician if you have any of the following symptoms:
- Worsening redness around or significant drainage from incision sites
- Persistent fever over 101 degrees (Fahrenheit) or chills
- Productive cough
- Persistent nausea or vomiting
- Prolonged soreness or no relief from prescribed pain medication
- New or increasing right shoulder pain
If you have any questions about the need for laparoscopic appendectomy surgery, alternatives, procedure cost, insurance or billing, physician training and experience, or have questions about surgery, you are encouraged to ask office staff or your physician.
Written by:
Horatio Asbun, M.D.
Director of Minimally Invasive Surgery Programs
John Muir Health
Jacklyn J. Schuchardt, RN, MSN, CNOR
Clinical Nurse Specialist, Surgery
John Muir Medical Center, Walnut Creek Campus
Walnut Creek, California
Diane M.Graham, RN, MSN, CNOR
Perioperative Clinical Nurse Specialist, John Muir Medical Center, Concord Campus, Concord, CA