Laparoscopic Appendectomy

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 abdomen. 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 appendix will be removed, and the inside of your abdomen cleaned to avoid infection. With a laparoscopic appendectomy, appendicitis may be cured, and the symptoms it causes relieved.

CARE AGREEMENT:

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

RISKS:

• Problems may happen during your laparoscopic appendectomy that may lead to a laparotomy (open surgery). Your stomach, intestines, blood vessels, or nerves may get injured or burned while having the surgery. You could also have trouble breathing, an infection, or too much bleeding during or after surgery. The special gas used may cause shoulder or chest pain for 1 to 2 days after your surgery.
  
  
• Without treatment, the appendix may rupture and your symptoms may get worse. 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). Ask your caregiver if you are worried or have questions about your surgery, medicine, or care.

GETTING READY:

Before your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask caregivers about directions for eating and drinking.
  
  
• If you are staying in the hospital after your surgery, bring your personal belongings with you. These include your bathrobe, toothbrush, denture cup (if needed), hairbrush, and slippers.
  
  
• You 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 caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  
  
• Tell your caregiver if you are taking any medicines. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Ask your caregiver before taking any medicine before your surgery.
  
  
• Your bowel may need to be emptied and cleaned out before the surgery. Caregivers may give you a liquid medicine called an enema. This will be put into your rectum (rear end) to help empty your bowel. Your caregiver will teach you how to do this.
  
  
• You may be given a pill to help you sleep.
  
  
• Do not wear contact lenses the day of your surgery. You may wear glasses. Wear socks to help you stay warm.
  
  
• Caregivers will insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your surgery.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your 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:

• You may be given medicine to help you relax or make you drowsy. You will be taken on a cart to the operating room and then moved onto a special bed. Your abdomen and genital area will be cleaned with soap and water. Sheets will be put over you to keep the surgery area clean. Caregivers may give a general anesthesia to keep you asleep during surgery. A catheter may be inserted to drain your urine. A nasogastric (NG) tube may also be inserted through your nose and down into your stomach. This tube keeps air and fluid out of the stomach during surgery.
  
  
• During your surgery, a small incision will be 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 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 caregiver more space to work in. Clips, cautery, loops, or special staplers may be used to separate the membrane of your appendix from the cecum. The appendix is then placed in a small bag and cut off using scissors.
  
  
• If the appendix is gangrenous (dead or decaying), a part or the whole cecum may also be cut off. The end of the small intestines (bowel) will then be attached to the remaining large intestines. The incisions will be 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 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 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 OK. When caregivers see that you are OK, 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 abdominal area. Ask your caregiver for more information about ways to prevent bleeding and take care of your incision.

Waiting room: This is a room where your family and friends can wait until you are ready for visitors. If your family leaves the hospital, ask them to leave a phone number where they can be reached.

CONTACT A CAREGIVER IF:

• You cannot make it to your appointment on time.
  
  
• You have questions or concerns about your surgery.

SEEK CARE IMMEDIATELY IF:

• You have a fever (increased body temperature).
  
  
• You have sudden trouble breathing.
  
  
• Your abdomen becomes very tender and hard.
  
  
• Your have a fast heartbeat.
  
  
• Your symptoms are getting worse.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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