Appendix Surgery Overview
Your side may hurt so much that you called your doctor. Or maybe you went straight to the hospital emergency room. If the symptoms came on quickly, you may have appendicitis. This is an infection of the appendix. Surgery can stop the infection and relieve your symptoms.
What is the Appendix?
The appendix is a small hollow outpouching located in the right lower side of the abdomen, the size of your little finger; it is attached to the area where the small intestine meets the large intestine or colon. The actual function of the appendix is still unknown, however surgical removal of the appendix is well tolerated and of no clinical implications on long-term patients health.
Pain & Other Symptoms
The opening of the appendix into the large intestine can get blocked by hard stool, tumors, thick mucus, or inflammatory diseases. Once obstructed, the wall of the appendix gets swollen, blood supply to the appendix gets cut off, and bacteria start growing inside the appendix causing inflammation and infection of the appendix. If left untreated, the swollen appendix can rupture causing spillage of stool into the abdomen and resulting in a generalized infection of the abdomen. Surgical removal of the appendix remains the gold standard treatment of appendicitis before it bursts.
Pain & Other Symptoms
- Symptoms tend to appear quickly, often over a day or two. Symptoms can include:
- Pain that starts in the center of your belly and moves to your lower right side
- Increased pain and pressure on your side when you walk
- Vomiting, nausea, or decreased appetite
- Fever or fatigue
- Diarrhea or constipation
Non-Surgical Treatment of Appendicitis
Appendix Surgery: Laparoscopic Appendectomy
Reaching the Appendix
One of two techniques may be used to reach the appendix. Your surgeon will discuss which is best for you:
- Open Surgery: One incision (about 2 to 3 inches long) is made in your lower right side. A bigger incision may be used if the appendix has burst.
- Laparoscopic Surgery: From 2 to 4 small incisions are used. One is near your belly button. The others are elsewhere on your abdomen. A laparoscope, a thin tube with a camera attached, is inserted through one incision. The camera shows the inside of your abdomen on a monitor. This image helps guide the surgery. Surgical tools are inserted in the other incisions. A stapler or a tie can be used to divide the appendix and this is placed in a plastic bag and removed through one of the incisions.
Finishing the Surgery
Risks & Complications
- Infection or bleeding from the incision site
- Infection or swelling in the abdomen, or leakage of bowel material
- Bowel ileus (slowness of bowel muscles) or bowel blockage
- Problems from anesthesia
After an Appendectomy
In the Hospital
Discharge Instructions after Appendix Surgery
You just had your appendix removed laparoscopically. This is a procedure performed through several small incisions. After surgery, be sure to have an adult drive you home and follow the guidelines on this sheet. Make a follow-up appointment as directed by our staff.
We encourage resuming walking and light activity immediately; as soon as you are sure you are not going to have issues with dizziness or lightheadedness. You may resume driving when it is comfortable to walk up and down stairs. Don’t plan on any strenuous activities, like sports or going to the gym, until your postop appointment. Your surgeon may have specific instructions to add to this; usually these are outlined to you before surgery. The bottom line: if it hurts, don’t do it!
Driving should not be attempted until you are off pain medications and able to go up and down stairs comfortably. You should be able to slam on the brakes to avoid an accident without causing any pain.
Use over-the-counter pain medications or a prescribed narcotic for your discomfort as needed. We recommend the following: Tylenol 1000 mg every 6 hrs around the clock for 2-3 days, in addition to Motrin/Advil/Ibuprofen 400-600 mg every 8 hrs and alternate these with Tylenol. Unless you are told differently by your surgeon or primary doctor, you can take 400 mg ibuprofen every 4-6 hours, or 800 mg every 8 hours, for the first 3-5 days after surgery, for a maximum dose of about 2400 mg/day (refer to the label for specific dosing based on age and weight). It is best if you can take some food with this medication. Tylenol is also acceptable to help with the baseline pain after surgery. It can be taken in conjunction with ibuprofen, and with your prescription (unless your prescription already contains acetaminophen–which is Tylenol). Be very careful not to exceed the dosage on the bottle. Taking more than 3 grams/day is not advisable. Most patients will be given a prescription for narcotics, if needed, but most will not need it. Prescription narcotic pain medications are there to help you recover comfortably, but stop them as soon as you are able. Side effects of nausea, vomiting, dizziness, fatigue, poor appetite, and above all constipation, are common. Do not use alcohol or drive if you are taking prescription pain medications. Blood thinners should only be restarted after surgery according to the plan discussed with you by your surgeon or prescribing doctor before surgery. If this was not made clear to you, call our office. All other medications should be resumed once you get home. Vitamins and supplements are not necessary to help you heal, unless you have a known deficiency. You may resume them after you get home if you wish. We would suggest sleep aids not be used while you are on narcotic pain medications.
If Difficulties Arise:
Please call us if any problems or questions arise. We can be reached any time, including evenings and weekends, by calling our office number (703) 359-8640 and selecting to speak to the on call physician.
Call your doctor if you have any of the following:
- Fever over 101°F or chills
- Increasing pain, redness, or drainage at an incision site
- Vomiting or nausea that lasts more than 12 hours
- Prolonged diarrhea
- Chest pain or shortness of breath
- Inability to urinate within 8 hours of discharge