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Laparoscopic Appendectomy In Children
What you should know
Laparoscopic appendectomy is surgery to remove your child's appendix. During this surgery, small incisions are made in your child's abdomen. A small scope and special tools are inserted through these incisions. A scope is a flexible tube with a light and camera on the end.
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- Problems may happen during your child's laparoscopic appendectomy that can lead to a laparotomy (open surgery). His stomach, intestines, blood vessels, or nerves may get injured or burned during the surgery. He could also have trouble breathing, an infection, or too much bleeding during or after surgery. The gas used during your child's surgery may cause vomiting. He may also have shoulder or chest pain for 1 to 2 days after his surgery.
- Without treatment, the appendix may rupture. 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).
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 healthcare provider 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 healthcare provider 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 to help empty him bowel. Your child's healthcare provider will teach you how to do this.
- Have your child wear socks to help him stay warm.
- Healthcare providers 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 healthcare provider 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 healthcare provider 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.
What will happen:
- Your child may be given medicine to help him relax or make him drowsy. He will be taken to the operating room. His abdomen and genital area will be cleaned with soap and water. Healthcare providers 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. Healthcare providers 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 healthcare provider more space to work in. Clips, cautery, loops, or 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 intestine (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 healthcare provider may then leave the skin open and allow it to heal on its own. He may place a drain in the abdomen to allow 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. Healthcare providers will watch him closely for any problems. When healthcare providers see that your child is okay, 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 healthcare provider may remove the bandages soon after your child's surgery to check his abdominal area.
This is an area where family and friends can wait until your child is able to have visitors. Leave a phone number or other means of contact where you can be reached if you leave the area.
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.
- 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 has blood or bile in it.
- Your child's symptoms are getting worse.
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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.