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Appendectomy: Removal of the Appendix, Appendicitis


Often when Appendicitis or inflammation of the appendix strikes an appendectomy is warranted. An appendectomy is the removal of the appendix, which is a narrow tube that attached the first part of the colon, called the cecum, to the rest of the body. The appendix is also referred to as the vermiform appendix or “wormlike appendage” because its shape and structure resemble that of a worm.




What Is It?


Usually appendectomies are carried out because of acute appendicitis. This is an acute condition that occurs because of inflammation of the appendix. Often what happens is the close-ended appendix because irritated, swollen and blocked. This can happen because mucous builds up in the appendix resulting from stool entering the appendix from the first part of the appendix or cecum.


Soon after this occurs often the stool becomes rigid or stiff, a process doctors refer to as fecalith. Other reasons for blockages to occur include swelling of lymphatic tissue in the appendix, which can be caused by bacteria present in the lymph system or an infection in the appendix. Any type of infection in or around the appendix can cause inflammation leading to an appendectomy. Inflammation can lead to tremendous pain and discomfort.


Appendicitis can lead to rupture of the appendix, which often occurs if the infection spreads throughout the wall of the appendix and often into the abdomen. Usually this does not happen but it can especially if the infection is left unchecked for some time.

Patients may report a lump or bulge in the lower right abdomen accompanied by pain or swelling. This is usually a sign of infection.  Pain is the most common symptom of appendicitis, the one that brings most patients to the doctor. Typically pain occurs in the abdomen and is widespread, but eventually the pain is narrowed to the central part of the abdomen. Eventually the pain narrows to the front and right hip bone and belly button.


If the appendix bursts the pain becomes present throughout the entire abdomen again. Many patients may report nausea and vomiting especially if intestinal obstruction occurs following obstruction of the intestines.




The Operation


First the surgeon makes an incision roughly three inches long through the abdominal wall to access the appendix. Then the surgeon searches for the appendix in the lower right abdomen, and after affirming no other problems exist, removes the appendix by freeing it from the abdomen and colon. A stitch must be made over the colon once the appendix is cut from the colon.


Sometimes an abscess or pocket of pus is present which must be drained through the skin. Then the surgeon will stitch the hole closed. Some surgeries are not performed using a laparoscope, which is a small telescope inserted through the abdominal wall allowing the surgeon to inspect the abdomen using a small puncture instead of a larger incision. If the surgeon confirms appendicitis then he or she can go in and remove the appendix without creating larger incisions in the abdomen, so there is less recovery time and less post-operative pain. The patient usually heals much faster.




Alternatives to Surgery


Typically the human body is very capable of healing its own infections but in patients with weakened immune systems or the elderly, and sometimes in younger children this is not always the case. Many times antibiotics are helpful in relieving the symptoms of appendicitis.




Before The Operation


Before the operation a doctor will likely rule out other causes for abdominal pain and may administer antibiotics to see if this clears up an infection prior to recommending surgery. A surgeon may also perform a laparoscopic exam to confirm the existence of appendicitis. You may be asked to avoid eating any food for 12 hours prior to a planned surgery to prepare for anesthesia.




After The Operation


If no peritonitis of perforation is present most patients can return home in two days. If the infection has ruptured the appendix patients will need to stay in the hospital for a few days longer, usually at least 4 days.




Possible Complications


Complications that can occur include perforation of the appendix and spread of the infection to the pelvis. Intestinal blockage can also occur. Very seldom sepsis can occur from rupture of the appendix. It is important to follow all of the prescribed medical advice to help to avoid any medical complications from this procedure.




General Advice


If you suspect you may have appendicitis see your doctor as soon as possible for treatment. It is far better to treat an infected appendix before serious complications like perforation or a ruptured appendix arise.




Estimated Costs for Appendectomy


The costs of an appendectomy arise from country to country. If your appendix bursts you will not be able to travel to have an appendectomy done. There are situations that arise where you may require emergency surgery to have your appendectomy performed so keep this in mind.


Country Costs Appendectomy
USA $ 6,700 - $28,000
Malaysia $ 2,400 - 4, 000
Singapore $ 3, 000 - 5,000
India $ 1,500 - 2,400
Thailand $ 2,000 - 4,500

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