The appendix is a small worm-like organ at the beginning of the large colon on the right hand side of the abdomen. Appendicitis is a medical condition that occurs when the appendix becomes inflamed and infected. It is considered a medical emergency and if left untreated, can lead to serious complications such as a ruptured appendix, allowing bacteria and other potentially harmful substances within the appendix to spill into the abdominal cavity. This spillage can rapidly spread infection, leading to peritonitis and sepsis – a body-wide response to infection that can cause tissue damage, organ failure, and death.
The most common symptom of appendicitis is pain in the lower right side of the abdomen that may start as a dull ache and intensify into a sharp pain. In some cases, it starts with discomfort by the belly button and then moves over to the right lower portion of the abdomen. Other symptoms include loss of appetite, nausea, vomiting, constipation or diarrhoea, and a low-grade fever. In some cases, the pain may also radiate to other areas of the abdomen or back. On moving or touching that part of the abdomen, there will be significant pain and discomfort. It is important to note that these symptoms can be similar to other medical conditions, and it is crucial to seek medical attention for a proper diagnosis.
The exact cause of appendicitis is still unknown, but it is believed to be related to a blockage in the appendix due to faecal matter, foreign objects or enlarged lymphoid tissue. This blockage can lead to inflammation and infection, causing the appendix to swell and become filled with pus.
An appendicectomy is a surgical procedure to remove the appendix, a small tube-shaped pouch attached to the large intestine, when it becomes inflamed and infected—a condition known as appendicitis. This common surgery is often performed as an emergency procedure to prevent a ruptured appendix, which can lead to serious complications.
If you’re diagnosed with appendicitis, prompt removal of the appendix is typically necessary. This surgical procedure is referred to as an appendicectomy. In cases where appendicitis is suspected but a definitive diagnosis has not been established, surgery is generally advised. This precautionary measure is taken to mitigate the risk of the appendix rupturing, which can pose significant health risks.
Despite its presence in the human body, the appendix does not serve any critical function, and its removal does not lead to any adverse long-term effects.
Performed under general anaesthesia, appendectomies can be done through open surgery or laparoscopically, the latter being less invasive with a quicker recovery time. The removal of the appendix typically resolves symptoms and prevents future occurrences of appendicitis.
How is removal of the Appendix performed?
In open surgery, a single long incision of around 5cm or more is made in the lower right side of the abdomen to remove the appendix. This type of surgery may be necessary if there is a rupture or abscess in the appendix or if the patient has had previous abdominal surgeries that make a laparoscopic approach difficult.
In laparoscopic surgery, 3 small incisions (0.5cm each) are made in the abdomen and a tiny camera and instruments are used to remove the appendix. This minimally invasive approach offers benefits such as shorter recovery time, less scarring, and reduced risk of infection.
Before the surgery, patients are given general anaesthesia to put them in a painless sleep. Then, small incisions are made in the abdomen and carbon dioxide gas is used to inflate the area, allowing for better visibility and space for the instruments. The surgeon then inserts a laparoscope (a thin tube with a camera attached) through one of the incisions to view the inside of the abdomen. Other small instruments are inserted through the other incisions to remove the appendix and seal off any bleeding vessels. After removing the appendix, the incisions are closed with stitches or surgical glue.
Our surgeon, Dr. Kan specialises in this minimally invasive technique and is proficient in treating a variety of cases, simple to complex. His daily practice includes appendicitis, gallstone disease, gastritis, complex hernias and more.
Appendicitis can affect anyone, but certain factors may increase the risk of developing this condition. These include a family history of appendicitis, a diet high in processed foods and low in fibre, and previous abdominal surgery. It is also more common in males and those between the ages of 10-30. In some cases, appendicitis may occur as a result of underlying conditions such as Crohn’s disease or ulcerative colitis.
Unfortunately, there is no sure way to prevent appendicitis. However, some studies have shown that maintaining a high-fibre diet may decrease the risk of developing appendicitis. It is also important to stay hydrated and maintain good hygiene to prevent any infections that could potentially lead to appendicitis. In some cases, individuals with a family history of appendicitis may choose to have their appendix removed preventatively.
Though antibiotics alone can be effective in treating appendicitis, especially in mild cases, there is a risk of recurrence. However, with surgery, the entire appendix is removed, making the risk of recurrence extremely rare. In patients who are not fit for surgery, or when surgery carries a significant undesired risk like in pregnant ladies with appendicitis, antibiotics alone can be used.
The recovery time for an appendectomy will vary depending on the type of surgery performed and the individual’s overall health. Typically, patients who have had a laparoscopic appendectomy can return to their normal activities within one to two weeks. Those who have had an open surgery may take longer to recover, up to four to six weeks. During the recovery period, it is important to follow your doctor’s instructions and allow your body time to heal properly. This may include taking pain medication, eating a healthy diet, and avoiding strenuous activities.
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