Appendectomy—Open Surgery
by Editorial Staff and Contributors
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.
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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:
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.
Anesthesia
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 one or more weeks as directed by your doctor.
- Care for the incision as instructed to prevent infection.
Call Your Doctor TOP
Call your 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 emergency medical services right away.
RESOURCES:
American College of Surgeons
https://www.facs.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
https://www.cag-acg.org
The College of Family Physicians of Canada
http://www.cfpc.ca
REFERENCES:
Appendectomy. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/healthlibrary/test_procedures/gastroenterology/appendectomy_92,P07686. Accessed January 10, 2018.
Appendectomy. Kids Health—Nemours Foundation website. Available at:
...(Click grey area to select URL)
Updated March 2013. Accessed January 10, 2018.
Appendicitis in adolescents and adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115548/Appendicitis-in-adolescents-and-adults . Updated October 25, 2017. Accessed January 10, 2018.
Short V, Herbert G, Perry R, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev. 2015;2:CD006506.
6/2/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use : 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.
Last reviewed November 2018 by
EBSCO Medical Review Board
Daus Mahnke, MD
Last Updated: 03/23/2015