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Open Appendectomy

WHAT YOU NEED TO KNOW:

An open appendectomy is surgery to remove your appendix through an incision in your lower abdomen.


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.
  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.
  • 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 to the room where your procedure or surgery will be done.
  • 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.
  • 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 catheter: This is a balloon-tipped catheter (thin tube) inserted through a vein in your neck or groin. The pulmonary artery (PA) catheter goes into the right side of your heart and continues to your pulmonary artery. The balloon is inflated to wedge the catheter in place. The PA catheter has a device in it that measures the pressure in your heart and lungs. The catheter is attached to a monitor that shows the pressure measurements. The measurements can also show caregivers how your heart responds to certain heart medicines.
  • 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 caregiver makes a cut through your lower abdomen. Your caregiver removes any pus or extra fluid that he sees. 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. 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 okay, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is okay. 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.
      • 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.
  • 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.
  • 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. 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 monitor. Your caregiver may do an ultrasound of your abdomen to look for infection.

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 or infertility. 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.
  • 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 or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  • With or without surgery, your appendix may have gangrene if the tissues in or near your appendix have died because of infection. You may get a serious blood infection which could be life-threatening. Without surgery, your appendix may burst and the contents of your appendix may spill inside your abdomen. If this happens, the infection may spread to other organs and your blood.

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.

© 2016 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.

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