Consumer Information

Laparoscopic Appendectomy In Children

WHAT YOU SHOULD KNOW:

Laparoscopic appendectomy is surgery to treat acute appendicitis. Acute appendicitis is a condition where the appendix becomes inflamed (swollen). The appendix is a small pouch that is attached to the cecum (first part of the large intestine). It is located in the lower right side of the abdomen (stomach). A piece of food or hardened stool may get trapped in the appendix. This may cause the appendix to get blocked, infected, swollen, and filled with pus. If left untreated, the appendix may rupture (burst) and cause severe abdominal pain and infection (peritonitis).
In a laparoscopic appendectomy, small incisions (cuts) are made in your child's abdomen (belly). Caregivers will insert special tools and a laparoscope through these incisions to do the surgery. A laparoscope is a long metal tube with a light and tiny video camera on the end. This gives caregivers a clear view of the abdominal area while watching the images on a monitor. During this surgery, your child's appendix will be removed, and the inside of his abdomen cleaned to avoid infection. With a laparoscopic appendectomy, your child's appendicitis may be cured, and the symptoms it causes relieved.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

RISKS:

Problems may happen during your child's laparoscopic appendectomy that may lead to a laparotomy (open surgery). His stomach, intestines, blood vessels, or nerves may get injured or burned while having the surgery. He could also have trouble breathing, an infection, or too much bleeding during or after surgery. The special gas used during your child's surgery may be left inside his body and cause vomiting (throwing up). He may also have shoulder or chest pain for 1 to 2 days after his surgery.
Without treatment, the appendix may rupture and his symptoms may get worse. If this happens, bowel contents and infected fluid may spread into the abdomen. This may lead to other serious medical problems such as sepsis (blood infection). Ask your child's caregiver if you are worried or have questions about your child's surgery, medicine, or care.

GETTING READY:

Before your child's surgery:

Write down the correct date, time, and location of your surgery.
Ask caregivers about directions for eating and drinking.
Ask your child's caregiver before giving any medicine on the day of your child's surgery. Bring all the medicines your child is taking, including the pill bottles, to the hospital.
If your child is staying in the hospital after his surgery, bring his personal belongings with you. These may include his clothes, toothbrush, feeding materials, or toys.
Your child may need to have a computed tomography (CT) scan or ultrasound. Other tests may also be needed, such as chest x-ray or blood or urine tests. Ask your child's caregiver for more information about these tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
Your child's bowel may need to be emptied and cleaned out before the surgery. This may be done using a liquid medicine called an enema. This will be put into his rectum (rear end) to help empty him bowel. Your child's caregiver will teach you how to do this.
Have your child wear socks to help him stay warm.
Caregivers will insert an intravenous tube (IV) into your child's vein. A vein in the arm is usually chosen. Through the IV tube, he may be given liquids and medicine.
An anesthesiologist may talk to you before your child's surgery. This caregiver may give your child medicine to make him sleepy before surgery.
You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your child's caregiver permission to do the surgery. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

TREATMENT:

What will happen:

Your child may be given medicine to help him relax or make him drowsy. He will be taken on a cart to the operating room and then moved onto a special bed. His abdomen and genital area will be cleaned with soap and water. Caregivers may give general anesthesia to keep him asleep during surgery. A catheter may be inserted to drain your child's urine. A nasogastric (NG) tube may also be inserted through his nose and down into his stomach. This tube keeps air and fluid out of the stomach during surgery.
During your child's surgery, a small incision will be made in his belly button to insert the laparoscope through. Caregivers will insert other instruments by making 2 to 3 smaller incisions at different places on his abdomen. The abdomen will then be inflated with a gas (carbon dioxide) to make the abdomen swell. This lifts the abdominal wall away from the internal organs and allows your child's caregiver more space to work in. Clips, cautery, loops, or special staplers may be used to separate the membrane of his appendix from the cecum. The appendix is then placed in a small bag and cut off using scissors. The end of the intestines (bowel) where your child's appendix was attached is then stitched and closed. The incisions are then closed by stitches or surgical tapes and covered with bandages.
If the appendix has burst or has holes in it, the abdomen will be thoroughly irrigated (washed out). This will be done after removing the appendix. Your child's caregiver may then leave the skin open and allow it to heal on its own. He may place a drain in the abdomen to allow pus and infected materials to leave your child's body.

After your child's surgery: Your child may be taken to a recovery room until he is fully awake. Caregivers will watch him closely for any problems. When caregivers see that your child is OK, he will be taken back to his hospital room. The bandages used to cover his stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your child's surgery to check his abdominal area. Ask your child's caregiver for more information about ways to prevent bleeding and take care of his incision.

Waiting room: This is a room where you and your family can wait until your child is ready for visitors after surgery. Your child's caregiver will find you there to let you know how the surgery went. If you or your family leave the hospital, leave a phone number where you can be reached.

CONTACT A CAREGIVER IF:

You cannot make it to your child's appointment on time.
Your child is irritable and crying more than usual.
You have questions or concerns about your child's surgery.

SEEK CARE IMMEDIATELY IF:

Your child has a fever (increased body temperature).
Your child has a fast heartbeat.
Your child has trouble breathing.
Your child is not able to eat or drink, or is urinating less or not at all.
Your child's abdomen becomes very tender and hard.
Your child's vomit (throw up) has blood or bile in it.
Your child's symptoms are getting worse.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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