Open Appendectomy

The traditional open method involves a two- to three-inch incision made in the lower right-hand side of the abdomen. The surgeon will remove the appendix through this incision.


The appendix is a thin tube that is about four inches long and is located at the junction of the small intestine and the large intestine. The function of the appendix is unknown, but one theory is that it serves as a storehouse for good bacteria.

Appendicitis is when the appendix becomes inflamed and needs to be removed or it can rupture, spilling infectious material into the abdominal cavity. This may occur as soon as 48 to 72 hours after symptoms begin. Appendicitis is considered an emergency and anyone with symptoms needs to see a doctor immediately.


Symptoms of Appendicitis

1.    Appendicitis may cause pain in the abdomen which may be described as follows:

·        May start in the area around the belly button and move over to the lower right-hand side of the abdomen, but may also start in the lower right-hand side of the abdomen.

·        Usually increases in severity over time.

·        May become more severe with moving, taking deep breaths, being touched, and coughing or sneezing.

·        May spread throughout the abdomen if the appendix ruptures.

2.    Other symptoms include, but are not limited to, nausea and vomiting, loss of appetite, fever and chills, constipation, diarrhea, inability to pass gas, and abdominal swelling.

3.    The symptoms of appendicitis may resemble other medical conditions. Furthermore, each individual may experience symptoms differently. Always consult your doctor for an accurate diagnosis and the appropriate treatment.

**It is important that patients with symptoms of appendicitis not take laxatives or enemas to relieve constipation as these can cause the appendix to burst. Pain medication should also be avoided as they can mask other symptoms.

The procedure is performed to remove the appendix when it is infected that causes abdominal pain, usually in the region of the belly button.

1.    The procedure is performed under general anesthesia so a complete physical examination is required before surgery. The patient may have to undergo blood tests and other diagnostics tests as well.

2.    The patient must avoid all food and water for at least six hours before the procedure.

3.    Certain medications may have to be discontinued before surgery, especially anticoagulants and blood thinners like aspirin. The patient should inform the doctor of all medications, supplements, and herbal supplements they are regularly taking.

4.    Inform the doctor of any allergies to medication, latex or anesthesia, and of any history of bleeding disorders.

5.    If the patient suspects that they might be pregnant, inform the doctor immediately.

In general, an appendectomy is performed as emergency surgery and requires a hospital stay. Procedures may vary depending on the patient’s condition and the doctor's practices. A perforated appendix can leak and infect the entire abdominal area, which can be life-threatening. If the appendix has ruptured or a pocket of infection (abscess) has formed, the patient’s abdomen will be thoroughly washed out during surgery. A small tube may be left in the belly area to help drain out fluids or pus. Each case is accessed individually and managed accordingly.

An appendectomy is performed under general anesthesia. This requires an intravenous (IV) line and continuous monitoring of vital signs by the anesthesiologist. In the open method an incision will be made in the lower right portion of the abdomen. Once the appendix has been located it will be tied off with sutures and removed. If the appendix has ruptured the abdomen will be washed out with saline and a drainage tube may be placed to remove fluids or pus.

Patients tend to recover quickly after a simple appendectomy. Most patients leave the hospital one to three days after surgery and can resume normal activities within two to four weeks. Recovery is slower and more complicated if the appendix has ruptured or an abscess has formed.

As the procedure is performed under general anesthesia, there are risks associated with that. Other possible complications from the surgery include:
  • Bleeding
  • Infection
  • A leak at the edge of the colon where the appendix was removed
  • Injury to adjacent organs such as the small intestine, ureter, or bladder.
  • Blood clot to the lungs
Call the Doctor
Consult the doctor immediately if the patient experiences any of the following:
  • Persistent fever over 101 degrees Fahrenheit (39 degrees Celsius)
  • Bleeding
  • Increasing abdominal swelling
  • Pain that is not relieved by medication
  • Persistent nausea or vomiting
  • Chills
  • Persistent cough or shortness of breath
  • Purulent drainage (pus) from any incision
  • Redness surrounding any of the incisions that is worsening or getting bigger
  • Inability to eat or drink

·        If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure.

·        Travelers to Thailand should plan to stay in the country for at least one week or for the entire duration of treatment.

·        If you plan to return home after the procedure, please speak to your doctor before making travel arrangements.

·        During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).

The success of the procedure depends on a number of factors such as the patient’s condition, post-procedure care. Please discuss the likelihood of success with your doctor before the procedure.


What if this procedure is not performed?

If an appendectomy is not performed quickly, the appendix could burst and spread infection throughout the body and into the bloodstream and abdomen, which can be life-threatening.

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