Appendicitis: removing the appendix

Types

• Inflamed appendix (most common)
• The appendix has burst (perforated)

What is the problem

The appendix is a small, finger-shaped pouch on the large bowel, in the lower right part of the belly. When its opening is blocked it becomes inflamed and swollen: this is appendicitis. It causes pain that often starts around the navel and moves to the lower right side, with fever and nausea.

Why an operation

An inflamed appendix can burst and spread infection inside the belly (peritonitis), which is dangerous. Removing it cures the problem for good. In some mild cases antibiotics alone are possible, but about 3 in 10 people need the operation within a few months, and nearly 4 in 10 within five years. This option is not advised if there is a stone in the appendix. Your surgeon will discuss what suits you.

How the operation is done

It is usually done as keyhole surgery (laparoscopy): through three small cuts, one at the navel, the belly is filled with gas and a camera and fine instruments are put in. The appendix is closed at its base with a stitch, clips or staples, cut off and taken out in a small bag. It usually takes 30 to 60 minutes. Sometimes a larger cut is needed.

Anaesthesia and the hospital stay

You will be asleep (general anaesthesia). After a simple appendicitis most people go home after one or two days. If the appendix had burst, the stay is longer, often a few days with antibiotics.

Possible risks

• Wound infection — about 1 to 3 in 100
• A collection of pus inside the belly (abscess), treated with antibiotics or drained — about 2 in 100; about 1 to 2 in 10 if the appendix had burst
• Changing to a larger, open cut — about 2 to 5 in 100
• Bleeding that needs treatment — less than 1 in 100
• Injury to the bowel, bladder or a blood vessel — rare, less than 1 in 100
• Scar tissue inside the belly that later blocks the bowel — about 1 in 100 over the years

After the operation

You may drink and eat again soon after the operation and walk the same day. The small wounds hurt for a few days; normal painkillers help. Most people return to everyday activities within one to two weeks. Avoid heavy lifting and sport for about two weeks, or as your surgeon advises.

Questions people often ask