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Appendix Surgery

Overview

A small worm like structure attached to the cecum at the beginning of the colon, on the lower right side of abdomen is the appendix. During first few years of life, appendix functions as part of the immune system, but after that it becomes redundant for our body. It does not have any known function after the first few formative years. Appendicitis is the sudden inflammation of appendix and if you are able to identify its symptoms, you can prevent serious appendicitis complications from occurring. A serious complication of appendicitis is peritonitis- an infection of the lining of your abdominal cavity which may occur if your appendix ruptures (perforates) and the contents of your intestines and infectious organisms invade the peritoneal cavity. Peritonitis is a medical emergency and must be treated immediately.

ABOUT THE APPENDIX

The appendix is a narrow, small, finger-shaped portion of the large intestine that is generally situated near junction of small and the Cecum or the large intestine on lower right side of the abdomen.

ABOUT APPENDICITIS

When the appendix gets suddenly inflamed, it results in Appendicitis.  Although the appendix has no function, but if an inflamed appendix is left untreated, it can burst, or cause infection. This occurs when the interior of the appendix becomes filled with something like mucus, bacteria, foreign materials, parasites or hard stools which cause swelling in the appendix, thereafter leading to irritation and inflammation. Appendix may perforate, allowing stool, mucus, and other substances to leak through and get inside the abdomen causing localized abscess or generalized infection of abdomen (peritonitis). This might require immediate appendix surgery.

SYMPTOMS

  • Pain in the abdomen- Pain may begin around the belly button and then get localized in right lower abdomen
  • Nausea/Vomiting
  • Loss of appetite
  • Fever usually occurs within several hours
  • Constipation
  • Abdominal pain which may worsen while walking or coughing
  • Rectal tenderness
  • Chills and rigours 

DIAGNOSIS

A thorough history and physical examination is required to diagnose appendicitis and begin appendix treatment. As patients usually have an elevated temperature, there is moderate to severe tenderness in the right lower abdomen, when the doctor physically examines it. In cases where inflammation has spread to the peritoneum, there can be frequent rebound tenderness. Rebound tenderness is pain that worsens when the doctor quickly releases his or her hand after gently pressing on the abdomen over the area of tenderness. 

These tests help in confirming the diagnosis of appendicitis:

  • Blood test to look for signs of infection
  • Urine test to rule out other conditions, such as a bladder infection
  • Computerized tomography (CT) scan or an ultrasound scan to see if the appendix is swollen

TREATMENT

In a laparoscopic appendix treatment, the appendix is removed in uncomplicated cases through Appendectomy. In case a CT scan shows that there is a swelling from a ruptured appendix, patient is treated for infection and appendix is removed after the infection and inflammation have gone away. The appendix is removed with instruments placed into small abdominal incisions. After anesthesia is administered, the abdomen is lined with an antibacterial solution and the peritoneal cavity is inflated with carbon dioxide. A small abdominal incision below to the belly button is made in the skin crease to allow the insertion of the laparoscope. Two or three small incisions more may be necessary to insert the laparoscopic instruments to dissect and remove the appendix. Next, the tissues and vessels surrounding the appendix are cut and tied. The appendix is put as a precautionary measure, to prevent infection, in a plastic bag before being removed.

Finally all the abdominal cuts are closed with clips, which are likely to leave insignificant scars. As a routine procedure the removed appendix is sent to the path lab for biopsy.

A laparoscopic appendix treatment in Delhi is available at all leading hospitals.

ADVANTAGES

  • Least post-operative pain
  • quicker recovery
  • Short hospital stay
  • Least post-operative complications
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