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Laparoscopic Appendectomy

AMBULATORY CARE:

What you need to know about a laparoscopic appendectomy:

Laparoscopic appendectomy is surgery to remove your appendix. The surgery is done through small incisions in your abdomen.

Abdominal Organs

How to prepare for surgery:

  • Arrange to have someone drive you home after surgery. The person will need to stay with you for 24 hours to make sure you do not have any effects from the anesthesia.
  • Tell your surgeon about all allergies you have. Tell him or her if you have ever had an allergic reaction to anesthesia or antibiotics. Antibiotics may be given before surgery to prevent an infection caused by bacteria.
  • Your surgeon will tell you how to prepare for surgery. Tell him or her about all medicines, supplements, and vitamins you currently take. He or she will tell you if you need to stop taking any of these before surgery, and when to stop.
  • You may be told not to eat or drink anything after midnight on the day of your surgery. You may need to use an enema the night before surgery. An enema will empty your bowel. Your surgeon will tell you if you need to do this, and how to do it.

What will happen during surgery:

  • You will be given general anesthesia to keep you asleep and free from pain during surgery. A catheter may be inserted to drain your urine. A nasogastric (NG) tube may be inserted through your nose and down into your stomach. This tube keeps air and fluid out of the stomach during surgery.
  • A small incision will be made in your belly button. Your surgeon will insert a laparoscope through the incision. This is a flexible tube with a light and camera on the end. Other instruments will be inserted into 1 to 2 smaller incisions in your abdomen. Your abdomen will then be inflated with a gas. This lifts the abdominal wall away from the internal organs and allows your surgeon more space to work. Your appendix will then be removed.
    Laparoscopic Surgery
  • Drains (thin rubber tubes) may be placed to remove liquid from your incision area. The incisions will be closed with strips of medical tape.

What to expect after surgery:

  • You may feel pain in your shoulder or chest from the gas used during surgery. This is normal and should go away in a day or two.
  • Bandages will cover your stitches to keep the area clean and dry to prevent an infection. A healthcare provider may remove the bandages soon after surgery to check your incisions.
  • You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots.
  • Medicines may be given to prevent a bacterial infection or to relieve nausea or pain.

Risks of a laparoscopic appendectomy:

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. You may get a blood clot in your leg or arm. A clot can break loose and travel to your lungs. A blood clot in your lungs can be life-threatening. Problems may happen that cause you to need an open appendectomy instead. Examples include a burst appendix or an infection or heavy bleeding in your abdomen.

Call your doctor or surgeon if:

  • Blood soaks through your bandage.
  • You feel full and cannot burp or vomit.
  • You cannot eat or drink anything.
  • You have increasing swelling in your abdomen.
  • You have a foul-smelling odor coming from an incision wound, or it is draining fluid.
  • Your wound is red, swollen, or has pus.
  • Your vomit is greenish, looks like coffee grounds, or has blood in it.
  • You are not able to have a bowel movement.
  • You have a fever.
  • You have chills, a cough, or feel weak and achy.
  • You have nausea or are vomiting.
  • Your pain is not helped with medicine.
  • You have questions or concerns about your surgery, condition, or care.

Medicines:

You may need any of the following:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Antibiotics help prevent or fight a bacterial infection.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-care:

  • Rest as needed to help with healing. You will need to go slowly and rest often. This will help protect the incision wounds. Do not lift anything heavier than your healthcare provider says is okay. Ask your provider when it is okay to drive and do your other normal daily activities.
  • Apply ice on your incision wounds. Ice helps prevent tissue damage and decreases swelling and pain. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it to your skin. Apply ice for 15 to 20 minutes every hour or as directed.
  • Prevent or relieve constipation. Constipation may make you strain to have a bowel movement. The strain cause damage before you have healed. Drink extra liquids during the day. Eat high-fiber foods. High-fiber foods include fruits and vegetables, whole-grain breads and cereals, and cooked beans.

Incision wound care:

  • Wash your hands before you care for the incision wounds.
    Handwashing
  • Check the wounds each day for signs of infection, such as swelling, redness, or pus.
  • Keep the wounds clean and dry. You may need to cover them when you bathe so they do not get wet.
  • Carefully wash the wounds with soap and water, or as directed. Dry the wounds and put on new, clean bandages.
  • Change the bandages when they get wet or dirty. The strips of medical tape will fall off on their own. If they do not fall off within 10 days, you can gently peel them off.

Follow up with your doctor or surgeon as directed:

Write down your questions so you remember to ask them during your visits.

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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.

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