What is Appendectomy? - Appendix Operation & Cost

Appendectomy is a common emergency abdominal surgery to remove your appendix if you have symptoms of appendicitis. You need emergency surgery if your appendix becomes swollen, infected, and sore. This is because if you have appendicitis, there might be a risk that your appendix might rupture. 

An appendix that has ruptured or burst can cause peritonitis, a severe life-threatening infection in your abdomen. So, go for an appendectomy within 48 to 72 hours of noticing the symptoms of the appendix. To know what appendectomy is and its cost in India read this piece.

Appendectomy is the standard surgical procedure that doctors perform to remove infected appendicitis. This will prevent the dangerous complications of appendicitis, a painful swelling of your appendix.

So, what is an appendix? 

An appendix is a minor tubular pouch-like attached to your large intestine, protruding from the rear section of your colon. It generally appears like a little tail and measures the length of your little finger. However, an appendix is located on the lower side, the right section of your abdomen. So, if you have appendicitis, you will surely feel a stinging pain in the exact area.

Here is what appendectomy treats, depending on the seriousness of the case:

• Acute Appendicitis: It happens quickly, within a few hours or days and requires prompt medical action. It might sometimes cause a perforated appendix if it goes unnoticed. A perforated appendix or an appendix which has burst releases harmful bacteria into the blood leading to emergency cases. Therefore, doctors suggest appendectomy or appendix operation to safely remove the infected appendix before it ruptures.
• Chronic Appendicitis: It is a rare condition where the inflammation or swelling of the appendix lasts longer. This causes intermittent and severe abdominal pain. This challenging diagnosis often causes complications such as bowel obstruction or intra-abdominal infections. One might feel more pain while coughing or walking, followed by other symptoms. 
• Simple Appendicitis: This is an inflamed appendix causing no sign of perforation or gangrene. People undergoing appendectomy within 48 hours of the symptoms recover quickly without leading to further complications.
• Complex Appendicitis: Complicated appendicitis is perforated appendicitis infecting your appendix. This can happen due to a bacterial, viral or parasitic infection in your digestive system. This enlarges the tissue of your appendix wall. Therefore, treatment for appendicitis is necessary if you have complex appendicitis.

There are two types of appendix surgery performed in major hospitals in India. While one is an open surgery, a standard procedure, the other is laparoscopic, a less invasive procedure.

1. Open Appendectomy

Open appendectomy is when the surgeon makes one large incision of about 2 to 4 inches in your lower right abdomen. Surgeons will then open the abdominal cavity to locate your appendix there. If your appendix has ruptured, there might be an abscess or a fluid that they will drain out before performing the surgery. 

Then, they will clean your abdominal cavity with a saline solution. Your appendix is then taken out, and the wound is stitched. Your doctor can choose to undergo this appendectomy procedure if you have a perforated appendix.

• Benefits:
  • Removes infected appendix in case it has ruptured
  • Low infection rate and no complications
• Success Rate After Surgery:
  • As per recent reports, the overall mortality rate for an open appendectomy is approximately 0.3% meaning it was successful.
• Cost of Surgery:
  
  • Approximately ₹ 30,000 to ₹ 60,000

2. Laparoscopic Appendectomy

Laparoscopic appendectomy causes less pain than open appendectomy. This procedure is less invasive, and your surgeon will make a minor incision of about 1 to 3 cuts in your abdomen. Appendectomy steps begin as your doctor inserts a small port through this incision. Through this port, they will insert a cannula or a small tube. 

A cannula is used to enlarge your abdominal cavity via carbon dioxide gas. After removing the cannula, they will insert a laparoscope, a long thin tube with a camera and a tiny light attached. The camera will clearly show the surgery to your surgeon, who will locate your appendix and conduct the surgery. The appendix is then removed through one of the incisions. 

During this surgery, your surgeon might require an open appendectomy, depending on the seriousness of your appendix. 

• Benefits:
  • A less invasive method with smaller incisions
  • Shorter hospital stay and faster recovery
  • Less pain and scarring post-surgery
  • Low risk of appendectomy complications and wound infections
  • Rapid return to normal activities of life
• Success Rate After Surgery:
  • As per recent studies, almost 166 men and 180 women underwent laparoscopic appendectomy resulting in a success rate of almost 88%.
• Cost of Surgery:
  • Approximately ₹ 55,000 to ₹ 1,20,000

Since appendectomy is a serious surgery, you should consult a physician whenever you feel any appendix symptoms. Also, if you feel a sudden protruding pain near your belly button that continues towards your lower abdomen, you should consult a doctor immediately. 

However, here are the preparations you need to make during the surgery:

• Medication: As prescribed by your doctor, you must stop taking certain medications before the surgery. Anti-inflammatory medicines such as Ibuprofen, Advil, and Naprosyn should be avoided until and unless prescribed by your doctor. Also, stop taking blood-thinning anticoagulant medicines that might affect blood clotting.
• Food and Drinks: You must not consume food or drinks 8 hours before surgery. Also, anaesthesia is safer on an empty stomach. However, you should avoid food that can cause constipation. They are dairy products, meat, frozen food, pasta, sugar products and beverages that contain caffeine.
• Alcohol and Tobacco: Doctors will ask you to avoid alcohol and tobacco before the surgery as this may cause further complications. Also, consuming alcohol or tobacco will reduce the chances of healing.

Every surgery comes with its risks and complications. It all depends on your health condition and your recovery time. In this regard, some of the risks and post-appendectomy complications include:

• Wound infection causing swelling and redness in your abdomen
• Haematoma or bleeding under the skin that causes swelling
• Hernia, post appendectomy is a common risk
• Blocked bowels
• Damage to other organs
• Problem due to anaesthesia

You might experience additional risks depending upon surgery. In that case, it is ideal to consult your physician.

As soon as you are diagnosed with appendicitis, your physician will ask you to undergo certain tests. This is useful for evaluating your health condition. Additionally, if your doctor finds certain symptoms caused due to appendicitis, they will check stiffness in the lower right abdomen section. 

To rule out any other health conditions such as gastroenteritis, kidney stones, etc., they will ask you to do the following tests to do before surgery:

• Urine test
• Complete blood count test or CBC
• Pelvic exam
• X-ray
• Ultrasound test
• Pregnancy test to rule out chances of ectopic pregnancy
• Electrocardiogram (ECG/EKG)
• Stress test
• Chest X-ray

You might feel a bit uncomfortable due to the anxiety from the surgery. Your doctor will ease the situation for you by detailing this surgery. Your medical team will continuously monitor your health condition and perform further tests to determine if your body is ready for surgery.

In most cases of appendectomy, you must stay in the hospital for a few days. You will either undergo an open appendectomy or laparoscopic surgery. This will depend upon your health condition. Here is what you expect during this surgery:

• As your surgery begins, you are put into a deep slumber as nurses will give you sedatives.
• After all the formalities, they will take you to the surgery table, and an anesthesiologist will check your blood pressure, breathing, heart rate and oxygen levels.
• Depending upon the surgery, a small or large incision will be made to remove the appendix from your body.
• In case there is any serious issue where the appendix has perforated or burst, your surgeon will clean it with saline.
• Then he will drain out the abscess and clean the abdominal cavity.
• After removal of the infected appendix, they will stitch your incision area.
• They will bandage the area to avoid getting infected.

Nurses will shift you to your ward; an oxygen mask may stay for a few hours until you regain consciousness. However, a medical team will continuously monitor your health condition.

Well, most of you have this query about what to do after appendix surgery. There are certain things you require to follow post-surgery and after doctors discharge you. They are:

• Post-surgery, the medical team will take you to a recovery room. There they will monitor your heart rate and other significant health conditions. 
• If you had an open appendectomy, you would have to stay a few more days in the hospital until partial recovery. 
• Doctors will prescribe antibiotics and medications that you will have to consume.
• A thin tube will be inserted into your abdomen through your nose to remove air and stomach fluids you might swallow.
• A few hours post-surgery, you can consume liquid food or drink liquids.

However, when you go back home, here are the things that you need to keep in mind:

• Keep your incision area dry and clean.
• Bathe according to instructions given by your doctor.
• Sometimes the incision area might ache. Consume medicines as prescribed by your doctor.
• Patients who had laparoscopic surgery might feel pain due to the insertion of carbon dioxide. Consuming medicines as approved by your doctor will remove this irritation soon.
• Some regular check-ups and follow-ups are necessary post-surgery. You can resume your daily activities slowly

You should immediately call your doctor in case you notice the following complications:

• Sudden fever above 101 degrees Fahrenheit and chills 
• Redness, swelling, irritation or pain near the incision area
• Nausea and vomiting
• Sudden loss of appetite
• Breathlessness and coughing 
• Cramping and abdomen ache
• Diarrhoea or constipation lasting for more than 3 days

As soon as you notice these symptoms, be sure to call away your nearest physician. He/She will diagnose the issue and immediately take action.

According to recent studies, antibiotics might be an option in case you have any reservations regarding appendectomy. Some people might feel uncomfortable undergoing surgery. In that case, antibiotics might be an option but not a long-term solution. 

When doctors diagnose that you have appendicitis, they will suggest you move for surgery. This will reduce further complications that might arise in future. 

According to Comparing Outcomes of Antibiotic Drugs and Appendectomy or CODA, more than 30% of patients underwent appendectomy. This was because they were sure antibiotics were not working, and they were facing appendix pains. 

Sometimes doctors prescribe antibiotics for uncomplicated appendicitis, and patients have also been cured from that. However, patients with appendicolith or a stone-like component inside the appendix fail to recover from antibiotics alone.

Having said that, it all depends on you and your body condition. You can try antibiotics if you feel that they can resolve this persistent issue. Notice if your problem or pain persists, then you can go for surgery after consulting your doctor.