Removal of the appendix called appendectomy is performed when appendicitis is suspected. Right low abdominal pain, fever and elevated white blood cells account are common symptoms and signs of appendicitis which usually occurs when a blockage develops between the appendix and the intestine. This leads to infection, swelling and distension. If the appendix is not removed it can lead to life threatening perforation or rupture. The most common treatment of appendicitis is appendectomy, which is almost always performed on emergency bases.
Laparoscopic techniques requires only tiny key hole incisions or puncture wounds. To get inside your abdomen your surgeon will make a small key hole incision near your belly button known as umbilical port with the tube called trocar. Gas will then pumped through this port to pop up your abdomen, so its content can be view easier. Next, your surgeon will insert laparoscope through this port. The laparoscope is tiny tube with the tiny camera at the end of it that projects the images on the monitors to guide your surgeons work. Using the laparoscope your surgeon will examine the image of your appendix on the monitor to confirm that it red and swollen. If your appendix needs to be removed additional ports will be created.
Your surgeon will pass surgical instruments through this other ports to grasp the appendix. Another instrument will be used to separate the appendix from the intestine and close the end with staples. The appendix then will placed in specimen bags and then removed through the hole. At the end of the procedure the laparoscope and surgical instruments will be removed. A port valve will be left in place briefly to aloud a gas to escape from the abdomen. The incisions will be closed with the sutures followed by skin glue or skin closure tape.
If your appendix can not be removed laparoscopically your surgeon will switch to an open procedure. Reasons for switching to open procedure include
- an extensive infection or abscess,
- perforated appendix which means that there is hole in it,
- dense scar tissue from previous abdominal surgery,
- difficulty viewing the organs with laparoscope,
- bleeding problems during the operation.
An open appendectomy is done directly through slightly larger abdominal incision over your appendix, or through the midline incision as needed. The surgeon will tight up appendix with sutures and remove it. Then the incision will be closed with sutures or staples.