Appendicitis is the inflammation of the appendix, a pouch-like organ in the lower right side of the abdomen. Surgery for appendicitis is called an appendectomy.
- About 7% of Americans will get appendicitis in their lifetimes.
- Laparoscopy is the surgical method of choice, which involves making small incisions in the abdomen to minimize scarring, pain, and improve recovery.
- Appendicitis most commonly occurs in teens and young adults but can present at any age.
What is the appendix?
The appendix is a pouch-like organ that extends off the colon in the lower right side of the abdomen. Although the appendix serves no physiological function, it can lead to problems if it gets infected. Essentially a pouch, the appendix can become closed off if digestive matter or bacteria gets lodged in its opening. When this happens, the appendix can become infected, inflamed, and painful—a condition known as appendicitis.
What are the symptoms?
Appendicitis often causes pain in the right lower abdomen, although it can sometimes be centered around the belly button or left side. Other symptoms include fever, nausea, vomiting, and loss of appetite.
Particularly worrisome signs, such as abdominal rigidity or guarding, can be a sign of ruptured appendicitis, which is a surgical emergency.
How is it diagnosed?
Appendicitis can be initially diagnosed with an abdominal ultrasound. The diagnosis modality of choice in younger patients, ultrasound is safe, cost-effective, and radiation-free. CT scan of the abdomen is the imaging of choice for evaluation of more complicated cases of appendicitis, such as ruptured appendicitis or an appendix poorly visualized on ultrasound.
It is important to contact a doctor if you experience sudden onset abdominal pain that lasts for more than several hours, with or without fever, as early diagnosis of appendicitis improves outcomes.
What are the treatments?
Depending on the severity of the symptoms, appendicitis can be treated medically or surgically.
For uncomplicated appendicitis, some patients may choose to defer surgery in preference of antibiotic treatment. The major benefit of medical intervention is avoiding the potential complications of surgery, but it carries a risk of the appendicitis recurring.
Other patients may choose to undergo surgery to remove the appendix—an appendectomy—which will completely treat the appendicitis and prevent recurrence.
For complicated appendicitis, such as a ruptured appendix, surgery is emergently warranted to prevent bloodstream infection and death.
What is the outlook?
Acute appendicitis has a low mortality rate (0.2-0.8%). Appendectomy, like all surgical interventions, has a risk of complications, such as bleeding and infection, which a surgeon will explain in detail when discussing treatment options. The vast majority of patients tolerate surgery and recover to their normal selves.
What is a laparoscopy appendectomy?
An appendectomy is a surgical procedure to remove the appendix, a non-functional organ attached to the colon. Laparoscopy refers to the method of surgery, which involves making small incisions in the abdomen to minimize scarring, pain, and improve recovery. Some surgeons may offer robotic appendectomy, a variation of laparoscopic surgery that uses a robotic surgical machine to improve precision. In certain complicated cases, the surgery may need to be converted from a laparoscopic to an open surgery.
Who performs this procedure?
A general surgeon.
How is the laparoscopic procedure done?
The surgery is performed under general anesthesia. The abdominal area is disinfected and draped appropriately. Several small cuts are made in the abdomen, through which a surgical camera and instruments are inserted to visualize and remove the appendix. The appendix is excised and removed through one of the small abdominal incisions. The incisions are then sutured, and the operation is complete.
How long does the procedure take?
An appendectomy usually takes about one hour.
What are the risks and complications of an appendectomy?
As a surgical intervention, appendectomy carries a small risk of bleeding, infection, and injury to the abdominal organs. Be sure to speak with a surgeon about any concerns about potential surgery risks when discussing treatment options.
What tests/treatments might you need first?
Abdominal imaging, either with ultrasound or CT scan. Some patients may choose to try antibiotics for uncomplicated appendicitis before undergoing surgery.
What to expect after the procedure?
The recovery time after appendectomy depends on the type of surgery performed. A laparoscopic surgery will have a recovery time around 1-3 weeks, while an open surgery may take longer. Cases of ruptured appendicitis may require a tube drain after the procedure.
Normal function is expected after recovery. No changes to diet or lifestyle are necessary.
If you suspect you have an urgent medical issue like appendicitis, contact your medical provider immediately or go to the closest emergency room.
If you have any questions for our Acute Care team, contact s at (212) 342-1734.