Laparoscopic appendicectomy

This is a minimally invasive procedure requiring a general anaesthetic. In most occasions it is performed as an emergency operation but sometimes it can be done as a planned operation. The operation takes place through small incisions on your abdomen, 0.5-1cm typical size, through which gas is inflated in order to create space and make internal organs easy to see. A tiny camera (laparoscope) is then inserted into the abdomen guiding the insertion of further specialised laparoscopic instruments which are used to examine the inside of the abdomen and remove the appendix. Depending on the degree of pus or contamination inside the abdomen sometimes a small drain may be left in the abdomen to drain any remaining fluid. This is removed after a few days.

Benefits of laparoscopic appendicectomy

The benefits of a laparoscopic procedure compared to an open procedure are:

• less discomfort following the procedure and return back to normal activities much faster.
• reduced risk of bleeding and wound infections,
• less risk of developing a collection of pus inside the abdomen
• less risk of developing scarring inside the abdomen with the subsequent risk of bowel obstruction,
• smaller abdominal scars offer a better cosmetic result.

Laparoscopy also allows the surgeon to examine the inside of the abdomen to exclude other causes for the abdominal pain and direct treatment towards potentially a different cause for your symptoms rather than just remove the appendix.

Recovery

After the procedure you will wake up in a hospital room. Laparoscopic appendicectomy normally requires an overnight stay in hospital but sometimes patients may need to spend a few days in hospital if there has been pus inside the tummy. If it is a planned operation you may go home on the same day. You are typically expected to go home once you are eating and drinking, are able to manage the pain and walk unaided and have passed some urine. It normally takes a few days to fully recover from a laparoscopic appendicectomy and return back to work but it varies from person to person and depends on their general health and the nature of their work. You should avoid any heavy object lifting or strenuous exercise for at least 6 weeks to reduce the risk of developing a hernia.

Risks of the operation

A laparoscopic appendicectomy performed by an experienced laparoscopic surgeon has a lower rate of complications compared to an open procedure and is normally reasonably safe. These include complications common to all surgical procedures such as infection, bleeding, blood clots, heart problems, pneumonia, urinary retention, anaesthetic risks and complications specific to this operation such as developing a collection inside the abdomen. On certain occasions an appendix which looks normal may be removed if the pain has occurred before and no other cause for the pain can be found. This is because sometimes conditions affecting the inside of the appendix that cannot be seen with the naked eye can be causing your symptoms.

On certain occasions if a laparoscopic procedure is not feasible due to a mass that has developed inside the abdomen or widespread contamination an open operation may be performed. Open procedures involve the use of general anaesthesia. A skin incision is made on the right side of the abdomen over the appendix or in the middle of the tummy (laparotomy) in order to remove the mass or part of the bowel. Recovery after an open appendicectomy or laparotomy is slower and may take a number of weeks before you can return back to normal activities.