Patient education: Appendectomy (The Basics)

What is appendectomy? — Appendectomy is surgery to remove the appendix. It is the main treatment for appendicitis, which is when the appendix gets infected and inflamed (figure 1).

This surgery can be done in 2 ways:

●Laparoscopic surgery – During laparoscopic surgery, the doctor makes a few small cuts, or "incisions," in the belly. Then, they insert long, thin tools through the cuts. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to know where to cut and what to remove. Then, they use the long tools to do the surgery.

You might be able to return to normal activities sooner if you had a laparoscopic surgery than if you had an open surgery.

●Open surgery – During an open surgery, the doctor makes a larger cut in the lower belly to remove the appendix.

If your appendix has burst, your surgery will probably be more complicated than it would be if it had not burst. As a result, your cuts might be larger or you might spend more time in surgery. Your recovery might also take longer. In rare cases, the doctor might start by doing laparoscopic surgery, but have to change to an open surgery.

How do I prepare for an appendectomy? — You might need surgery right away after coming to the hospital with belly pain. Other times, the doctor can schedule a time for your surgery. The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get imaging tests, such as a CT scan or an ultrasound. Imaging tests create pictures of the inside of your body.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your surgery – The doctor will want you to "fast" before surgery. This means not eating or drinking anything for a period of time. In some cases, you might be allowed to have liquids until a short time before the procedure. The staff will talk with you about when to stop eating or drinking before your surgery.

●Lowering the risk of infection – You might be asked to wash the area with a special soap. The staff might also give you antibiotics before surgery.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during an appendectomy? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Most appendectomies are done with general anesthesia. This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will remove your appendix. If the appendix has burst, the doctor will wash away any material that spilled out when the appendix burst.

●The doctor will close your cuts (incisions) and cover them with clean bandages. In rare cases, the doctor will place a drain to get rid of extra fluid.

●The procedure usually takes 30 to 60 minutes.

What happens after an appendectomy? — After the procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. Most people can go home within 1 to 2 days after an appendectomy. Some people go home the same day of surgery.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine to help with pain if needed. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of an appendectomy? — Your doctor will talk to you about all of the possible risks and answer your questions. Possible risks include:

●Bleeding

●Infection

●Injury to nearby organs

●Bowel contents might leak into the abdomen

●Abscess (a small pocket of pus)

●Ileus (when the bowel has trouble moving air, fluid, and food)

What else should I know? — Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Appendectomy – Discharge instructions (The Basics)
Patient education: Appendicitis in adults (The Basics)
Patient education: Appendicitis in children (The Basics)