Patient Information for Laparoscopic Appendectomy
Surgery from SAGES
WHAT IS THE APPENDIX?
The appendix produces a bacteria destroying protein called immunoglobulins which help fight
infection in the body. Its function, however, is not essential. People who have had
appendectomies do not have an increased risk toward infection. Other organs in the body take
over this function once the appendix has been removed.
WHAT IS A LAPAROSCOPIC APPENDECTOMY?
Appendicitis is one of the most common surgical problems. One out of every 2,000 people has
an appendectomy sometime during their lifetime. Treatment requires an operation to remove the
infected appendix. Traditionally, the appendix is removed through an incision in the right lower
In most laparoscopic appendectomies, surgeons operate through 3 small incisions (each ¼ to
½ inch) while watching an enlarged image of the patient's internal organs on a television
monitor. In some cases, one of the small openings may be lengthened to 2 or 3 inches to
complete the procedure.
ADVANTAGES OF LAPAROSCOPIC APPENDECTOMY
Results may vary depending upon the type of procedure and patient's overall condition.
Common advantages are:
Less postoperative pain
May shorten hospital stay
May result in a quicker return to bowel function
Quicker return to normal activity
Better cosmetic results
ARE YOU A CANDIDATE FOR LAPAROSCOPIC APPENDECTOMY?
Although laparoscopic appendectomy has many benefits, it may not be appropriate for some
patients. Early, non-ruptured appendicitis usually can be removed laparoscopically.
Laparoscopic appendectomy is more difficult to perform if there is advanced infection or the
appendix has ruptured. A traditional, open procedure using a larger incision may be required to
safely remove the infected appendix in these patients.
HOW IS LAPAROSCOPIC APPENDECTOMY PERFORMED?
The words "laparoscopic" and "open" appendectomy describes the techniques a surgeon uses
to gain access to the internal surgery site.
Most laparoscopic appendectomies start the same way. Using a cannula (a narrow tube-like
instrument), the surgeon enters the abdomen. A laparoscope (a tiny telescope connected to a
video camera) is inserted through a cannula, giving the surgeon a magnified view of the
patient's internal organs on a television monitor. Several other cannulas are inserted to allow
the surgeon to work inside and remove the appendix. The entire procedure may be completed
through the cannulas or by lengthening one of the small cannula incisions. A drain may be
placed during the procedure. This will be removed before you leave the hospital.
WHAT HAPPENS IF THE OPERATION CANNOT BE PERFORMED
OR COMPLETED BY THE LAPAROSCOPIC METHOD?
In a small number of patients the laparoscopic method is not feasible because of the inability to
visualize or handle the organs effectively. When the surgeon feels that it is safest to convert the
laparoscopic procedure to an open one, this is not a complication, but rather sound surgical
judgment. Factors that may increase the possibility of converting to the "open" procedure may
Extensive infection and/or abscess
A perforated appendix
A history of prior abdominal surgery causing dense scar tissue
Inability to visualize organs
Bleeding problems during the operation
The decision to perform the open procedure is a judgment decision made by your surgeon
either before or during the actual operation. The decision to convert to an open procedure is
strictly based on patient safety.
WHAT SHOULD I EXPECT AFTER SURGERY?
After the operation, it is important to follow your doctor's instructions. Although many people feel
better in just a few days, remember that your body needs time to heal.
You are encouraged to be out of bed the day after surgery and to walk. This will help
diminish the risk of blood clots in your legs and of soreness in your muscles.
You will probably be able to get back to most of your normal activities in one to two
weeks time. These activities include showering, driving, walking up stairs, working and
engaging in sexual intercourse.
If you have prolonged soreness or are getting no relief from the prescribed pain
medication, you should notify your surgeon.
You should call your surgeon and schedule a follow up appointment for about 1-2 weeks
following your operation.
WHAT COMPLICATIONS CAN OCCUR?
As with any operation, there are risks including the risk of complications. However, the risk of
one of these complications occurring is no higher than if the operation was done with the open
Removal of a normal appendix
A leak at the edge of the colon where the appendix was removed
Injury to adjacent organs such as the small intestine, ureter, or bladder.
Blood clot to the lungs
It is important for you to recognize the early signs of possible complications. Contact your
surgeon if you have severe abdominal pain, fever, chills or rectal bleeding.
WHEN TO CALL YOUR DOCTOR
Be sure to call your physician or surgeon if you develop any of the following:
Persistent fever over 101 degrees F (39 C)
Increasing abdominal swelling
Pain that is not relieved by your medications
Persistent nausea or vomiting
Persistent cough or shortness of breath
Purulent drainage (pus) from any incision
Redness surrounding any of your incisions that is worsening or getting bigger
You are unable to eat or drink liquids