Appendectomy – treatment, effect and risks

Appendectomy

Appendectomy is the removal of the appendix of the appendix . It is carried out surgically at the patient’s request for prophylaxis and in acute appendicitis .

What is an appendectomy?

The appendix and the appendix are regarded as evolutionary biological remnants. Almost all mammals have both a cecum and a worm process, but these parts of the intestine no longer serve a function in humans. They are located at the transition from the small intestine to the rectum at the end of the digestive tract, usually in the right lower abdomen – if the organs are arranged in a mirror image, they are on the left.

The appendix can become inflamed and then become a life-threatening hazard as it can rupture and spread septic material into the abdomen – appendectomy is thus a life-saving operation and at the same time the only effective treatment for acute appendicitis. If this is recognized in good time, the appendectomy can be carried out in good time and is now relatively low-risk for the patient in this condition.

The patient usually stays in the hospital for a few days after the appendectomy until the circulation has stabilized and the surgical pain has become bearable, after which he can be discharged. The appendix can also be removed if the patient wishes to avoid an appendectomy in an emergency.

application and function

Appendectomy can be performed either on healthy people or in the case of acute appendicitis. The first case is a preventive operation that is done on a voluntary basis, for example when the patient is afraid of developing appendicitis. More often, however, it is an emergency operation that is carried out when appendicitis has occurred.The diagnosis of appendicitis can be made by ultrasound and blood tests , so that the appendectomy can usually be carried out in good time before the disease becomes life-threatening for the patient. The appendix is ​​not removed, but only the inflamed appendix.

An exceptional case is appendectomy when the appendix has already ruptured. In this case, the tissue of the inflamed appendix has torn, inflamed fluid has entered the abdominal cavity and, if left untreated, would lead to fatal sepsis .

methods and procedures

An appendectomy does not mean the removal of the appendix, only the appendix. The patient is put under general anesthesia, and then the abdominal cavity is opened through an incision that is as small as possible in the lower abdomen.

Either the appendix is ​​separated by ligature or electrocoagulation, for which purpose it is first brought through the incision on the abdominal wall. This allows the surgeon to assess the condition of the appendix. Alternatively, a laparoscopic procedure can be used, which is used together with the ligation of the appendix. In the case of severe inflammation, a drainage can then be inserted.

What does the patient have to consider?

Since appendicitis is an acute condition, there is not much time for prevention. The appendectomy is often an emergency operation, so it must be assumed that the patient is not sober as in the case of normal surgical interventions. Before the operation, patients are asked about their medical history and existing illnesses, their blood group is also determined and the patient is informed about the risks of the operation.

Follow-up care can take more time, since the patient is usually no longer in a critical condition. Initially, patients stay in the hospital for a few days after the appendectomy to allow circulation to stabilize and pain to be treated.

The wound care of the fresh scar is explained to the patient upon discharge, if necessary, followed by a follow-up appointment with his general practitioner. It is possible to administer antibiotics after the appendectomy in order to completely kill other pathogens.

process and implementation

After the patient has been anesthetized, the abdominal wall is opened. There are conventional and laparoscopic procedures. The best known is the so-called “bikini cut”, the alternating cut. This is carried out on the side of the lower abdomen near the bikini zone. The underlying muscle layers are pushed apart for the procedure.

If the findings are unclear or if the patient is obese, the lower abdominal incision can be considered, as this can be expanded as desired to rule out differential diagnoses or to reach the appendix at all.

The laparoscopic procedure, on the other hand, requires an access of 10 cm just below the navel and two half as long working accesses just above the pubic hairline. The appendectomy can finally be performed through these openings by separating the inflamed appendix and disinfecting and invaginating the stump.

Self-service or health insurance – who bears the costs?

An appendectomy for acute appendicitis is emergency surgery. This is fully covered by health insurance.

It is different when the appendix is ​​removed at the patient’s request, for example because the patient wants to avoid an acute situation from the outset. Such an appendectomy is paid for by the patient himself, since there is no medical indication for the procedure until inflammation of the appendix is ​​actually diagnosed. However, the health insurance company would also bear the treatment costs for complications in this case.

Risks, dangers and complications

In addition to the usual risks associated with a surgical procedure, appendectomy also harbors the risk of pathogens remaining in the abdominal cavity. The risk of sepsis or infection of other internal organs is particularly high when the appendix has already ruptured. In this case, the appendectomy is followed by treatment with highly effective antibiotics in the intensive care unit.Other risks are tears in the freshly closed appendix stump, tears in the abdominal scar, intestinal abscesses , peritonitis , adhesions with painful long-term consequences such as intestinal obstruction and injuries to neighboring organs.

In addition to the rupture of the inflamed appendix before or during the appendectomy, pathogens can also be spread to other parts of the abdomen through the operation itself, which would result in symptoms of inflammation after the successful appendectomy. Finally, with any surgical scar there is a risk of complicated healing, which can make the scar painful even years later.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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