An appendectomy, or appendix removal, is the primary treatment for an appendix that is inflamed or has burst. An inflamed appendix can lead to life threatening complications, so an appendectomy is often an emergency surgery.
An appendectomy is a surgery to remove the appendix. It’s the main treatment for an inflamed appendix, commonly known as appendicitis.
The appendix is a small, tube-shaped pouch that’s attached to your intestines on the lower right side of your abdomen. Its exact purpose is unknown. Your body can still function without it.
It’s important to seek treatment right away if you’re having symptoms of appendicitis, such as:
- abdominal pain that spreads to the lower right side
- abdominal swelling
- constipation or diarrhea
- loss of appetite
If you don’t receive treatment for appendicitis, your appendix can rupture (burst).
A ruptured appendix can release bacteria and other toxins into your abdominal cavity. This can lead to a longer hospital stay and could be life threatening.
An appendectomy is performed to treat appendicitis. This infection can occur when the opening of the appendix gets clogged with bacteria and stool. It causes your appendix to swell and become inflamed.
Without prompt treatment, your appendix could burst. If that occurs, bacteria from your appendix can spread into your bloodstream and cause sepsis, a life threatening response to infection.
Other dangers of a ruptured appendix include:
- peritonitis, which is a type of abdominal inflammation usually caused by an infection
- abscess, which is a collection of pus
Both are serious and require immediate treatment.
When to seek help
Appendicitis is a medical emergency. If you have symptoms, see a doctor or go to the emergency room immediately.
You’ll need treatment in order to prevent complications.
An appendectomy is a common and usually safe procedure.
However, there are some risks associated with the surgery, including:
- internal bleeding
- blood clots
- injury to organs such as the bladder or intestines
The risks associated with untreated appendicitis are much more severe than those associated with an appendectomy.
Did you know?
Some children and adults with appendicitis, including some whose appendix has ruptured, won’t require surgery and will be able to treat their condition with antibiotics alone.
Once you’re at the hospital, a doctor will perform a physical exam and ask about your medical history.
During the physical exam, the doctor will gently push against your abdomen to locate the source of your abdominal pain.
When discussing your medical history, be prepared to tell the doctor about any prescription or over-the-counter medications you’re currently taking. The doctor will tell you whether you need to stop taking any of them before your procedure.
Also, let the doctor know if you:
- are pregnant or believe you may be pregnant
- are allergic or sensitive to latex or certain medications (such as anesthesia)
- have a history of bleeding disorders
If the doctor catches your appendicitis early, they may also order blood and imaging tests. They may not perform these tests if you need an emergency appendectomy.
Timing of your surgery
If your appendix has already ruptured, you’ll likely have an emergency appendectomy that same day.
If your appendix hasn’t ruptured, your surgery may take place a few days after you receive an appendicitis diagnosis. A delayed appendectomy is also known as an interval appendectomy.
Regardless of whether you have an emergency or interval appendectomy, you’ll need to stop eating and drinking (water included) for a few hours beforehand.
According to 2017 guidelines from the American Society of Anesthesiologists, you should avoid heavier meals for at least 8 hours before an elective procedure that requires anesthesia. This includes fried foods, fatty foods, and meat. Having a light meal up to 6 hours before your procedure is safe. You can also have clear liquids (except for alcohol) for up to 2 hours beforehand.
Before your appendectomy, you’ll receive intravenous (IV) fluids and medications, including antibiotics.
General anesthesia is typically used during this procedure, which means you’ll be asleep. Sometimes spinal anesthesia is used instead to numb you from the waist down.
There are two types of appendectomy: open and laparoscopic.
The type of surgery you undergo will depend on several factors, including the severity of your appendicitis and your medical history.
Surgery typically lasts around 1 hour.
During an open appendectomy, a surgeon makes one incision in the lower right side of your abdomen. They remove the appendix and then close the wound with stitches.
This procedure allows the surgeon to clean the abdominal cavity if your appendix has burst.
A surgeon may choose to perform an open appendectomy if:
- your appendix has ruptured, and the infection has spread to other organs
- they don’t have experience in laparoscopic surgery
- you have had abdominal surgery in the past
- you have a lump called an appendix mass in the area where your appendix burst
During a laparoscopic appendectomy, a surgeon reaches your appendix through a few small incisions in your abdomen. They use a small, narrow tube called a cannula to inflate your abdomen with carbon dioxide. The gas allows them to see your appendix more clearly.
After the surgeon has inflated your abdomen, they’ll insert a laparoscope through the incision. A laparoscope is a long, thin tube with a bright light and a camera at the front.
The camera displays images on a screen, allowing the surgeon to see inside your abdomen. Your appendix is tied off with stitches and removed. The small incisions are then cleaned, closed, and dressed.
Laparoscopic surgery typically has fewer risks and a shorter recovery time than open appendectomy. It may be the best option if you:
- don’t have any complications from appendicitis
- are at risk of surgery complications
- have overweight or obesity
- are older
- are pregnant
Appendectomy is safe during pregnancy. In fact, it’s safer for both you and your baby to have surgery right away than to let appendicitis go untreated.
Delaying surgery increases your risk of complications such as:
The laparoscopic technique is preferred if you are pregnant and need to have an appendectomy.
Appendicitis is more common in people ages 10 to 19 years than in any other age group. Appendectomy is the primary treatment for children and teens, just as it is for adults.
Laparoscopic appendectomy is preferred for children with appendicitis because it:
- leads to fewer infections
- causes less pain during recovery
- requires a shorter recovery time than open appendectomy
Before this procedure, a child with appendicitis will receive IV fluids and antibiotics to treat any possible infection.
They’ll also receive general anesthesia. Your child will be asleep and won’t feel any pain during the surgery.
The risks associated with appendectomy in children include:
- bowel blockage
Your child should be able to return to their regular activities after recovering from an appendectomy. They can live a full, healthy life without an appendix.
Once your appendectomy is over, your healthcare team will observe you for a few hours.
They’ll closely monitor vital signs such as your respiratory and heart rates. They’ll also check for any reactions to the anesthesia or procedure.
How much time you spend in the hospital will depend on:
- your overall health
- whether your appendix bursts
- whether you have open or laparoscopic surgery
- how your body reacts to the surgery
If your appendicitis isn’t severe, you may be able to return home the same day as your surgery.
If you receive general anesthesia, you’ll need someone to drive you home. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure.
The first few days of recovery
In the days following your appendectomy, you may feel moderate pain in the areas near the incisions. Any pain or discomfort should improve within a few days. The surgeon may prescribe medication to relieve the pain.
You’ll also need to avoid bathing or showering for a few days so that the incisions stay dry. You may have to adjust your diet, opting for only bland or clear liquid options.
Before you leave the hospital, your surgeon will provide specific instructions on do’s and don’ts.
Risk of infection
You might need to take antibiotics after surgery to prevent an infection. You can also reduce your risk for infection by keeping the incisions clean.
In the days after your surgery, watch for signs of infection, such as:
- redness or discoloration around the incision
- swelling around the incision
- fever above 101°F (38.3°C)
- loss of appetite
- stomach cramps
- constipation or diarrhea that lasts for more than 3 days
Although there’s a small risk of infection, most people recover from appendicitis and an appendectomy.
A full recovery from a laparoscopic appendectomy typically takes 1 to 2 weeks. After an open procedure, it may take 4 to 6 weeks to fully recover.
During this time, the surgeon will probably recommend that you limit physical activity so your body can heal. In addition, you’ll have a follow-up appointment with them in the first few weeks after your appendectomy.
Expect to see some scarring near the incisions. The scars from laparoscopic surgery are smaller than those from open surgery. Any scars should fade over time.
An appendectomy is the standard treatment for appendicitis.
An appendix that bursts can lead to serious complications, so it’s important to have this procedure quickly. Laparoscopic surgery causes less pain and results in a faster recovery time than open surgery, but it may not be right for everyone.
You may have relatively little time to prepare for your surgery. However, this procedure is safe for people across various age groups and during pregnancy. A surgeon can let you know what to expect during and after surgery.