Appendicectomy is also called as appendectomy or appendisectomy. It is a surgical procedure, through while the vermiform appendix is removed. The procedure usually needed to be performed to be an emergency procedure.
Appendectomy is usually performed laparoscopically, which is a minimally invasive procedure for the surgery. Laparoscopy procedure is usually performed when the result of the diagnosis is doubtful. It is also done, when it scar has to be hidden in the public hair line or umbilicus. The procedure takes more time than that of the open surgery and it is also expensive.
Selection of the candidates
Candidates, who have acute appendicitis are eligible candidates. However, the candidates, who are with COPD and cardiac diseases are not considered as good candidates for laparoscopic appendectomy.
The patients experiences acute appendicitis.
- Stump appendicitis
- General anesthesia may have poor risk
- Complicated appendicitis
- Extensive pelvic surgery that might be happened before
For preexisting disease conditions, the laparoscopic appendectomy is not recommended by most of the surgeons.
Laparoscopic Appendectomy Procedure
- Just before the surgery, antibiotics are to be given, in case the signs are of sepsis.
- General anesthesia is given to the patient
- The patient has to be positioned supine.
- The abdomen is examined to be prepared and draped.
- There are four incisions required to make on the body for the procedure. These are McBurney’s incision that has another term as Grid iron incision, Lanz Incision, Para-median incision and Rutherford Morrison incision.
- In case there is any mass a small incision would be made through the mass. If the mass is not present, the incision is to be made through the McBurney’s point.
- The abdominal wall is opened, by opening its layers.
- Surgeons put the efforts to preserve and maintain the abdominal wall integrity. So, the steps are taken accordingly.
- After peritoneum is entered, the surgeon identifies the appendix. Then it is mobilized, followed by ligation.
- The stump of the appendix is buried and it is preferred to be done by some of the surgeons. The purpose is to invert the stump, in order to point it towards caecum.
- After the procedure is completed, each of the abdominal wall layers is closed.
- Finally, the skin is get closed with the help of stitches or staples.
- The wound or the surgical site is dressed.
- Pneumoperitoneum or abdomen inflation with gas
- When a pregnant woman develops appendicitis, the procedure performed has the fetal death risk at perioperative period is from 3% to 5%.
- For the same pregnant woman, the risk of fetal death, in the perforated appendicitis is 20%.
There are many benefits when the procedure is performed through the laparoscopy.
- Decreased abdominal incision
- Decreased pain
- Decreased postoperative complications
- Earlier recovery and ready for the easy mobilization
- Shorter stay in hospitals
- Better and improved cosmesis
- Faster and easy recovery and can soon get back to the work
- Decreased visibility of the scars
After the procedure is successfully performed, the patient is taken to the recovery room. Since laparoscopic appendicectomy is a minimally invasive procedure, the recovery will be faster, than the one performed through open surgery. Usually, the hospital stay demanded after the surgery is about 2 days. However, for the patients, who have ruptured or perforated appendix, need about 6 days of hospital stay. The overall recovery period varies from person to person. There will be a scar of two to three inches that is heavily bruised initially.
Cost of Laparoscopic Appendectomy
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