Avg ER Wait
Checking ER Wait Time
The feed could not be reached
Retry?
--
mins

Appendectomy -- Open Surgery

Definition

An appendectomy is the removal of the appendix. The appendix is a pouch that is attached to the large intestine.

Reasons for Procedure

An appendectomy is often done as an emergency procedure to treat appendicitis. Appendicitis is inflammation of the appendix. It can be caused by an infection or obstruction.

Inflamed Appendix
nucleus image
Copyright © Nucleus Medical Media, Inc.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Infection
  • Damage to other organs
  • Reaction to anesthesia

Some risk factors that make complications more likely include:

  • Smoking
  • Ruptured appendix
  • Older age, especially age 65 years and older
  • Obesity
  • Diabetes
  • Chronic lung or heart disease
  • Pregnancy

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Blood and urine tests
  • Your doctor may need detailed pictures of your appendix. These can be made with:
  • X-rays
  • Ultrasound
  • CT scan

Antibiotics will be started right away. Appendicitis is an emergency condition. Surgery is almost always done right away.

Anesthesia

General anesthesia will be used. You will be asleep during the procedure.

Description of the Procedure

A short incision will be made in the right lower abdomen. The doctor will be able to see the appendix through this cut. The appendix will be detached from surrounding tissue. The surgeon will stop any bleeding from blood vessels. The appendix will then be tied off and cut out. The incisions will then be closed with stitches or staples.

If the appendix has ruptured, a warm water solution mixed with antibiotics will be used to wash out the inside of the abdomen. A catheter will then be placed to drain any fluid that builds up. Sometimes, with a rupture, the surgeon will only close the muscle layers and leave the skin open. The open skin wound will then be packed with a moist gauze dressing.

After Procedure

The removed tissue is examined by a pathologist.

How Long Will It Take?

1-2 hours

Will It Hurt?

Anesthesia prevents pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

You may be in the hospital for up to three days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:

  • Pain medications
  • Antibiotics to prevent infection
  • Medication to prevent blood clots
  • Getting out of bed and moving around within 24 hours of your surgery

If your appendix ruptured, drainage tubes will be removed after a few days.

At Home

Recovery takes about 4-6 weeks. When you return home, do the following to help ensure a smooth recovery:

  • You may be given antibiotics to fight infection. Take all the medications ordered even if you start to feel better.
  • Keep the incision area clean and dry.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Wash your hands before changing the dressing.
  • Rest and take it easy for 1-2 weeks. Slowly increase activities as approved by your doctor.
  • Do not exercise or do heavy lifting for one or more weeks as directed by your doctor.

Call Your Doctor

Call doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Increased redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Increased abdominal pain
  • Lightheadedness or fainting
  • Passing blood in the stool

If you think you have an emergency, call for medical help right away.

Revision Information

  • American College of Surgeons

    http://www.facs.org

  • National Digestive Diseases Information Clearinghouse

    http://digestive.niddk.nih.gov

  • Canadian Association of Gastroenterology

    http://www.cag-acg.org

  • Canadian Family Physician

    http://www.cfp.ca

  • Appendectomy. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test%5Fprocedures/gastroenterology/appendectomy%5F92,P07686. Accessed December 13, 2013.

  • Appendectomy. Nemours Kids Health website. Available at: http://kidshealth.org/parent/system/surgery/appendectomy.html. Updated March 2013. Accessed December 13, 2013.

  • Appendicitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 21, 2013. Accessed December 13, 2013.

  • Townsend C, Beauchamp DR, eds. Sabiston Textbook of Surgery. 17th ed. Philadelphia, PA: WB Saunders; 2003.

  • 6/2/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.