What is laparoscopic appendectomy?
Laparoscopic appendectomy is a minimally invasive surgical procedure to remove the appendix from the body. The small, pouch-like tissue extending from the large intestine is removed by making few small incisions in the abdomen, inserting video camera, light fitted scope (laparoscope) and special tools and removing the appendix by following images created on a screen. Laparoscopic appendectomy allows the surgeon to see inside the abdomen and make surgical cuts without directly viewing inside.
Why does one need laparoscopic appendectomy?
Very mild appendicitis may be treated with antibiotics, but most cases require surgical removal of the appendix, often under emergency situations. Appendicitis cannot be left untreated because that increases the chances of it bursting and causing fatal complications like abscess or infection.
Laparoscopic surgery is the preferred mode of treatment for most appendicitis as it leaves minimal scarring post the procedure and offers short recovery period as compared to traditional appendectomy. Patients may leave the hospital a few days after the surgery and can expect complete recovery in two weeks.
Which specialist should be consulted in case of signs and symptoms?
Intense abdominal pain must be shown to a general practitioner who will determine if the cause of the pain is due to appendicitis. The person may be hospitalised immediately if appendicitis is determined.
What are the screening tests and investigations before the surgery?
A physical examination of the person’s abdomen to check for pain upon applying pressure on the lower right side and other questions regarding the symptoms help diagnose appendicitis. Physical examination is generally sufficient but the following tests may be conducted to confirm diagnosis:
- Blood test to check for infection
- Urine test to check for infection
- Imaging tests (ultrasound scan, magnetic resonance imaging (MRI) scan, abdominal x-ray, CT scan)
What is the procedure for laparoscopic appendectomy?
Laparoscopic appendectomy is performed under general anaesthesia. The surgeon makes three or four incisions in the abdomen of about 0.25 to 0.50 inches long. The light and camera-fitted laparoscope is inserted to view the location of the inflamed appendix and guide the other surgical tools.
The surgeon inserts a grasper to retract the large intestine towards the liver. Another instrument holds and elevates the appendix in the laparoscope’s view while it is being held together towards the abdominal wall. A grasper creates a gap under the base of the appendix to allow another instrument to pass through the gap and surround the appendix near the junction with the intestine. The appendix is amputated from the gastrointestinal tract and the intra-abdominal cavity is rinsed with saline water before sealing off the remaining tract. The entire procedure takes about two hours.
What are the known complications of the surgery?
As a rule laparoscopic appendectomy is not performed in the following situations:
- Burst appendix
- Tumour in the digestive system of patient
- Women in first trimester of pregnancy
- Patients having undergone a prior abdominal surgery
Laparoscopic appendectomy is a safe procedure but like any other surgery, may pose the following risks:
- Post-operative sepsis
- Wound infection
- Inability to locate the appendix in patients with severe, perforated appendicitis
What precautions or steps are necessary to stay healthy and happy before and after laparoscopic appendectomy?
The patient must restrict intensive physical activity in the first few weeks after the surgery. It may take between four to six weeks to regain normal activities. Recovering patients must not lift heavy weight or perform strenuous exercise in the initial weeks, though recovery is much faster with laparoscopic appendectomy as compared to traditional surgery.
Clear fluids will be allowed on the first day after surgery. Introduction to solid foods should be gradual to allow the bowel to heal properly.
How can the disorder be prevented from happening or recurring?
A high fibre diet can reduce a person’s risk towards appendicitis as fibre makes stools softer, reducing the risk of stools getting stuck in the appendix.
“Appendicitis – Treating appendicitis,” webMD.boots.com, http://www.webmd.boots.com/digestive-disorders/tc/appendicitis-treating-appendicitis
“Laparoscopic Appendectomy,” eMedicine.Medscape.com, Yevgeny Shuhatovich, DO; Chief Editor: Kurt E Roberts, Joseph Michael R Zuniga, Aleksander Bernshteyn, Evan Brad Goldstein, Danny A Sherwinter, MD, Jerzy M Macura, MD, Mary L Windle, PharmD, http://emedicine.medscape.com/article/1582228-overview#a15
“Laparoscopic Appendectomy,” WebMD.com, Healthwise Staff, http://www.webmd.com/digestive-disorders/laparoscopic-appendectomy