Appendectomy—Open Surgery

Definition    TOP

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

Reasons for Procedure    TOP

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

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Possible Complications    TOP

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

Complications are more common in people older than 65 years of age. Some risk factors that make complications more likely include:

  • Smoking
  • Ruptured appendix
  • Obesity
  • Diabetes
  • Chronic lung or heart disease
  • Pregnancy

What to Expect    TOP

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:

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


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

Description of the Procedure    TOP

A short incision will be made in the right lower abdomen. The appendix can be viewed through this incision. The appendix will be detached from surrounding tissue. Any bleeding from the blood vessels will be stopped. 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    TOP

The removed tissue is examined by a pathologist.

How Long Will It Take?    TOP

1-2 hours

Will It Hurt?    TOP

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

Average Hospital Stay    TOP

You may be in the hospital for up to 3 days. If you have any problems, you may need to stay longer.

Post-procedure Care    TOP

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.

Your bowels will work more slowly than usual. Chewing gum may help speed the process of your bowel function returning to normal.

At Home

Recovery takes about 4-6 weeks. When you return home:

  • 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 1 or more weeks as directed by your doctor.
  • Follow your doctor's instructions.

Call Your Doctor    TOP

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

  • 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 emergency medical services right away.


American College of Surgeons
National Institute of Diabetes and Digestive and Kidney Diseases


Canadian Association of Gastroenterology
The College of Family Physicians of Canada


Appendectomy. Johns Hopkins Medicine website. Available at:
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Accessed December 1, 2014.
Appendectomy. Nemours Kid's Health website. Available at:
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Updated March 2013. Accessed December 1, 2014.
Appendicitis in adolescents and adults. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated October 27, 2014. Accessed December 1, 2014.
6/2/2011 DynaMed's Systematic Literature Surveillance
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Mills E, Eyawo O, Lockhart I, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
3/23/2015 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Short V, Herbert G, Perry R, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev. 2015;2:CD006506.
Last reviewed November 2015 by Donald Buck, MD
Last Updated: 3/23/2015