Appendectomy

An appendectomy is the surgical removal of the appendix, a small pouch attached to the large intestine in the lower right abdomen. It is one of the most common emergency surgeries performed in the United States, with over 300,000 procedures done annually.

The procedure can be performed laparoscopically through small incisions or as an open surgery through a single larger incision. Laparoscopic appendectomy is now the preferred method for most patients.

An appendectomy is performed to treat appendicitis, a condition where the appendix becomes inflamed and filled with pus. Without treatment, an inflamed appendix can rupture, spreading infection throughout the abdomen (peritonitis), which can be life-threatening.

Symptoms include sudden pain that begins around the navel and shifts to the lower right abdomen, nausea, vomiting, fever, and loss of appetite.

Because appendectomy is usually an emergency procedure, preparation time is limited. You will be asked to fast (no food or drink). Blood tests, urinalysis, and imaging (CT scan or ultrasound) are performed to confirm the diagnosis. An IV line is started for fluids and antibiotics.

Under general anesthesia, the surgeon removes the appendix either laparoscopically (3 small incisions with a camera) or via open surgery (one 2-4 inch incision). The laparoscopic approach takes 30-60 minutes. If the appendix has ruptured, the surgeon will also clean the abdominal cavity and may place a drain.

After laparoscopic surgery, most patients go home within 24 hours. Open surgery may require 2-3 days of hospitalization. You can return to light activities in 1-2 weeks and full activities in 3-4 weeks. If the appendix ruptured, recovery takes longer and may include IV antibiotics.

Risks include wound infection, abscess formation, bowel obstruction, hernia at incision site, and reactions to anesthesia. Serious complications are rare, occurring in less than 5% of cases. The risk of complications increases if the appendix has ruptured.

In early uncomplicated appendicitis, antibiotics alone may be tried as a non-surgical alternative. However, studies show a 20-40% recurrence rate within 5 years. For most patients, surgery remains the standard of care due to its high success rate and low complication rate.

Appendectomy is covered by most health insurance plans as it is considered a medically necessary emergency procedure. Out-of-pocket costs depend on your deductible and copay. Medicare and Medicaid also cover this procedure.