Appendectomy

At a Appendectomy it is the surgical removal of the appendix appendix. The procedure is used for inflammation of the vermiform appendix.

What is the appendectomy?

An appendectomy is used when the appendix of the appendix (appendix vermiformis) is surgically removed. This happens when the appendix becomes inflamed. Most people refer to this condition as appendicitis.

The surgical removal of the appendix is ​​called appendix removal. Neither is correct, however, because only the vermiform appendix is ​​removed and not the entire appendix (caecum).

The appendix vermiformis is the process of the appendix, which reaches a length of approx. 10 centimeters. Due to the position of the appendix, which in a sense forms a dead end, inflammation can easily occur there, which then requires surgical treatment. This area has an entrance, but not an exit. The first successful appendectomy took place in 1735 at George's Hospital in London. The French surgeon Claudius Amyand (1680-1740) removed the vermiform appendix of an eleven-year-old boy by accident.

Function, effect & goals

An appendectomy is done when the appendix becomes inflamed. Inflammation is usually caused by the buildup of digestive debris. These primarily include fecal stones (hardened stool). Sometimes the appendicitis is also caused by foreign bodies or swelling of the mucous membrane. These causes can lead to an obstruction of the appendix inside, which in turn leads to bacterial inflammation. An appendectomy is particularly common in children and young adults between 4 and 25 years old.

An appendectomy is often necessary because appendicitis can have life-threatening complications. This can tear the inflamed intestinal wall, which doctors call a perforation or rupture of the appendix. Perforation of the appendix vermiformis occurs in up to 30 percent of all patients. This incident occurs in most cases 24 to 36 hours after the onset of appendicitis.

In very rare cases, the procedure also takes place because of tumors within the appendix, which can be both benign and malignant. These tumors are discovered by chance during a laparoscopy, as they do not cause any symptoms over a long period of time.

An appendectomy, which takes place under general anesthesia, can be performed either as a laparotomy or as a laparoscopy. During a laparotomy, the surgeon makes an incision 6 centimeters long in the right lower abdomen. Then he looks for the lower pole of the appendix. This is where the vermiform appendix usually emerges. After clamping off the supplying blood vessels, the appendix is ​​then severed by the surgeon. The remaining stump is sewn with a special seam, called the purse-string seam. To be on the safe side, the doctor sews up the wound twice. At the end of the appendectomy, he closes the abdominal wall again. The skin wound is closed by stapling or sewing.

The vermiform appendix can also be removed by laparoscopy. This is a laparoscopy called a laparoscopic appendectomy. The first step of the procedure is a small incision in the navel region. An optical device and camera are then inserted into the patient's abdominal cavity.

In order to get a better overview, a little gas is passed into the abdomen beforehand with a needle. This procedure gives the surgeon a better overview of the abdominal organs on the connected screen. The next step is to bring in the medical tools. Then the blood vessels of the appendix vermiformis are either tied with a thread or electrically boiled. Then the surgeon pulls a loop around the appendix and pulls it together. This is followed by the removal of the vermiform appendix. After removing the instruments, the gas is released and the incisions are sutured.

Risks, side effects & dangers

Appendectomy complications are very rare. They are conceivable if there are already adhesions or scarring in the area of ​​the appendix. However, these can also form after the operation, which leads to the risk of an intestinal obstruction.

An undesirable side effect of an appendectomy can be mechanical impairment of the abdominal organs, which in turn leads to bleeding. The occurrence of abscesses in the abdominal cavity or life-threatening inflammation of the peritoneum (peritonitis) are particularly dangerous complications. Wound healing disorders and the excessive formation of scars are also conceivable. Occasional hernias also occur in the abdominal region. Temporary sensitivity disorders caused by a nerve injury are also conceivable. Some patients experience persistent pain after the appendectomy. Various allergic reactions are also within the realm of possibility.

An operation of the appendix vermiformis is only not to be performed if the patient suffers from a very poor general condition or if he is unable to be anesthetized. However, this happens extremely rarely.

After the operation, the patient remains under observation for the time being. From the second day onwards, normal diets can be consumed again. The hospital stay usually lasts three to five days, depending on the individual findings. After a laparotomy, the patient has to take it easy for another four to six weeks. After a laparoscopy, the rest only lasts about 14 days.