Open Appendectomy

WHAT YOU SHOULD KNOW:

• An open appendectomy is surgery to remove your appendix. The appendix is a tube-shaped organ in the lower right side of your abdomen (stomach). Scientists do not know what an appendix does in a person's body. You may need an appendectomy if you have appendicitis. If you have appendicitis, your appendix is inflamed (swollen) or infected by germs called bacteria. Your appendix may become inflamed and infected if it becomes blocked. Some things that may cause your appendix to become blocked include stool, seeds, or tumors (growths). You may also need surgery if your appendix is injured or not in the right position.
  
  
• Your caregiver may press on parts of your body to see where you have pain. He may also do blood, urine, or imaging tests to check for appendicitis and other diseases. In an open appendectomy, your appendix is removed through an incision (cut) in your lower abdomen. Having your appendix removed may help relieve your symptoms, such as pain, vomiting, and fever (high body temperature). If your appendix bursts or has a hole in it, then infection may leak out into your abdomen. If your appendix is removed before bursting, you may be less likely to get a serious infection.

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:

• You may have pain, fever, or an infection after your surgery. You may have an allergic reaction to antibiotics or anesthesia medicine. Your organs may be damaged or push through your incision site. Scar tissue may form inside your body and cause tissue and organs to stick together (adhesions). Adhesions may cause bowel obstruction (blockage) or infertility (trouble getting pregnant). Your bowels may stop working. You may get an abscess, which is a pus filled pocket of tissue that can cause infection. You may need another surgery to help fix some of these problems.
  
  
• With or without surgery, your appendix may have gangrene. You may have gangrene if the tissues in or near your appendix have died because of infection. You may get a serious blood infection and you may die. Without surgery, your appendicitis may burst and the contents of your appendix may spill inside your abdomen. If this happens, the infection inside of your appendix may spread to other organs and your blood. Ask your caregiver for more information about your surgery, condition, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Antibiotics: You may be given antibiotic medicine through your IV to prevent an infection during or after surgery.
  
  
• 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. You are then moved to a table or bed.
  
  
• General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. This tube is called an endotracheal tube or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep and free from pain during surgery.
  
  
• Arterial line: An arterial line is a tube that is placed into an artery (blood vessel), usually in the wrist or groin. The groin is the area where your abdomen meets your upper leg. An arterial line may be used for measuring your blood pressure or for taking blood.
  
  
• CVP line: A CVP line is also called a central line. It is an IV catheter or tube. It is put into a large blood vessel near your collarbone, in your neck, or in your groin. The groin is the area where your abdomen meets your upper leg. The CVP line may be used to give medicines or IV fluids. It may also be hooked up to a monitor to take pressure readings. This information helps caregivers check your heart.
  
  
• Pulmonary artery line: A pulmonary artery line, or PA cath, is a kind of central line catheter. It is a thin tube put in a vein near your collarbone, or in your neck or groin. The tube is then guided through your heart and into a blood vessel that goes to your lungs. One end of this catheter is hooked to a machine called a monitor. The monitor shows numbers that tell caregivers how your heart and lungs are doing. The part of this catheter that is inside you may be used to give you medicine. You will need a chest x-ray after the PA line is placed, to be sure the line is where your caregiver wants it. You may have stitches on your skin where the line comes out. This holds the line in place.
  
  
• Nasogastric (NG) tube: A nasogastric tube is put into your nose and down into your stomach. The tube may be attached to suction (vacuum) to keep your stomach empty. You may need a NG tube if your stomach gets too full or if you throw up a lot after surgery. You may also need it if you cannot use your mouth to eat. An NG tube may also be used to help get your bowels working. Food or medicine may be given through your NG tube.

During your surgery:

• Your caregiver makes a cut through your lower abdomen. He cuts through the fat, tissue, and muscles under your skin. Your caregiver removes any pus or extra fluid that he sees. He may put his finger through the cut and feel for your appendix. If he does not feel the appendix, he makes the cut wider. Your appendix is carefully raised with special tools. Your caregiver puts clamps on the base of your appendix. He will tie nearby blood vessels to help prevent bleeding during surgery.
  
  
• Your caregiver removes your appendix and closes its stump with stitches or special staples. The stump may be placed back inside your bowel. Your caregiver will check for tumors or other problems in your abdomen. If your caregiver finds a tumor, he may remove the tumor and nearby tissue. Your caregiver may wash the inside of your abdomen to remove infection. If pus remains inside your abdomen, your caregiver may place a drain in your wound (surgery site). Your caregiver may also leave your surgical cut open to help remove infection. Your appendix or fluid from your abdomen may be sent to a lab for testing.

After your surgery: You will be taken to a room where you will rest until you wake up. Once your caregiver says it is OK, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK. If your caregiver left your cut open during surgery, then he may close it when he does not see infection anymore.

• Medicines:
  
  
  • Antibiotic medicine: Your caregiver may give you antibiotic medicine after your surgery. You may get this medicine in your IV or as a pill. This medicine is given to help treat or prevent infection.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
  
  
• Diet: You may be able to eat when bowel sounds are heard. Your caregiver will listen to your stomach for bowel sounds using a stethoscope. You may be given ice chips at first, and then liquids such as water, broth, juice, or soda pop. If you do not have problems after drinking liquids, caregivers may then give you soft foods. Some examples of soft foods are ice cream, applesauce, or custard. Once you can eat soft food easily, you may begin eating your usual diet.
  
  
• 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.
  
  
• Tests:
  
  
  • Blood tests:
    
    
    • You may need blood taken for tests to check for infection and other problems. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
      
      
    
    
  • CT scan:
    
    
    • This is also called a CAT scan or computed tomography. An x-ray machine uses a computer to take pictures of your abdomen to look at the organs and blood vessels in your abdomen, and to check for problems and abnormal changes. Your caregiver may use a CT scan to look for infection inside of your abdomen.
      
      
    • You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregivers see the pictures better. People who are allergic to iodine or shellfish (crab, lobster, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
    
    
  • Ultrasound:
    
    
    • An abdominal ultrasound is a test that is done to see inside your abdomen. Sound waves are used to show pictures of your abdomen on a TV-like screen. Your caregiver may do an ultrasound of your abdomen to look for infection.
      
      
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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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