What is appendix?
Appendix is a small finger like rudimentary organ located where small intestine and large intestine meets.
It is related to immunological function in foetal life, but its function in adult life is unknown.
After removal of appendix, there is no increased risk toward infections.
What is appendicitis? How does it occur?
Appendicitis is the inflammation of appendix.
Its cause is usually unknown and can occur at any age group.
Appendicitis is many cases is found to have food particle (appendicolith) blocking the opening of appendix into large intestine.
How do I know if I have appendicitis?
Most common symptom is pain in abdomen, starting around umbilicus, and then radiating towards right lower abdomen.
It may be associated with nausea, vomiting, decreased appetite, or fever.
How is appendicitis diagnosed?
Appendicitis is a clinical diagnosis. Your surgeon will examine you and come to this diagnosis.
Ultrasonography is first investigation to get which may pick up appendicitis.
Your blood tests may show increased Total Leucocyte Count (TLC).
Sometimes, difficult situations may require CT scan of the abdomen to look for appendicular inflammation, lump or abscess formation.
How is appendicitis treated?
The best treatment is surgical removal of appendix.
Mild appendicitis may temporarily be managed with antibiotics, but will require surgical removal on recurrent attacks.
How is appendix removal surgery performed?
Most cases these days are managed with Laparoscopic Appendicectomy.
Performed under General Anaesthesia (GA).
Usually three small punctures are made in the abdomen, approx. 5-10 mm in size.
A telescope is passed into one of the punctures to see inside the abdomen.
Using laparoscopic instruments, surgery is performed, and appendix is removed.
Usually skin is closed with absorbable sutures and need not be removed later.
A drain may be placed during the procedure in difficult situations, which would be removed after 24-48 hours.
What if operation cannot be performed by the laparoscopic method?
In a small number of patients (e.g. Extensive abscess, Perforated appendix, Generalised peritonitis, previous abdominal surgery, bleeding problems), the laparoscopic method cannot be performed.
If the surgeon feels that it is safer to convert the laparoscopic procedure to open one, it is not a complication, but rather sound surgical judgment.
The decision to convert to an open surgery is strictly based on patient’s safety.
What are the benefits of Laparoscopic Appendicectomy?
Early recovery after surgery.
Better cosmesis. Minimal scar on the abdomen.
Less pain.
Early return to work.
Can see whole of abdomen from inside using laparoscope, which may diagnose other problems which mimics appendicitis, like Meckel’s diverticulum in children, or tubo-ovarian pathology in females.
What if I do not get surgery done?
Acutely inflamed appendix can perforate to form localised abscess or generalised peritonitis.
This makes surgery difficult, many times requiring open exploration and prolonged hospital stay.
What complications can occur due to surgery?
While there are risks associated with any kind of operation, most laparoscopic appendicectomy patients experience a few or no complications and quickly return to normal activities.
Complications of laparoscopic appendicectomy are infrequent, but includes bleeding, infection, unintended injury to adjacent structures and leak from appendicular stump.
Is laparoscopy risky for people with other medical problems like Diabetes, Hypertension, Kidney disease or Morbid Obesity?
Not at all. On the contrary, minimization of the trauma to the body by Minimal Access Surgery (MAS) causes minimal disturbance of normal physiology.
Can laparoscopy be performed in children?
Yes, laparoscopic removal of appendix can be safely performed in paediatric population as well. Infact laparoscopy looks for other diseases as well which mimics appendicitis.
