Laparoscopic Appendectomy

WHAT YOU SHOULD KNOW:

Laparoscopic appendectomy is surgery to remove your appendix. During this surgery, small incisions are made in your 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.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Problems may happen during your laparoscopic appendectomy that can lead to a laparotomy (open surgery). Your stomach, intestines, blood vessels, or nerves may get injured or burned during the surgery. You could also have trouble breathing, an infection, or too much bleeding during or after surgery. The gas may cause shoulder or chest pain for 1 to 2 days after your surgery.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.

  • Without treatment, the appendix may rupture. When 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).

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Enema: You may need to have an enema before your surgery. This is liquid put into your rectum to help empty your bowel.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Nasogastric (NG) tube: An NG tube is put into your nose, and passes down your throat until it reaches your stomach. Food and medicine may be given through an NG tube if you cannot take anything by mouth. The tube may instead be attached to suction if caregivers need to keep your stomach empty.

During your surgery:

  • Your abdomen and genital area will be cleaned with soap and water. Sheets will be put over you to keep the surgery area clean.

  • During your surgery, a small incision is made in your belly button to insert the laparoscope through. Caregivers will insert other instruments by making 1 to 2 smaller incisions at different places on your abdomen. The abdomen is inflated with a gas (carbon dioxide) to lift the abdominal wall away from the internal organs. Clips, cautery, loops, or staplers are used to separate the membrane of the appendix from the cecum. The appendix is then placed in a small bag and cut off using scissors.

  • Your caregiver will also cut off a part or the entire cecum if you have a dead or decaying appendix. The end of the small intestine (bowel) is then attached to the remaining large intestine. 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 is thoroughly irrigated (washed out). This will be done after removing the appendix. Your caregiver leaves the skin open and allows it to heal on its own. He places a drain in the abdomen to allow infected materials to leave your body.

After your surgery:

You may be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is okay. When caregivers see that you are okay, you will be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your incisions.

  • Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.

  • Medicines: You may need any of the following:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

  • Monitoring: Caregivers may check for pulses on your arms or wrists. This helps caregivers learn if you have problems with blood flow after your surgery. You may also have any of the following:

    • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

    • Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

  • You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.

Learn more about Laparoscopic Appendectomy (Inpatient Care)

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