LAPAROSCOPY APPENDIX SURGERY IN AHMEDABAD

Appendectomy

The Condition

Appendectomy is the surgical removal of the appendix.The operation is done to remove an infected appendix. An infected appendix, called appendicitis, can burst and release bacteria and stool into the abdomen.

What are the common symptoms?

Abdominal pain that starts around the navel

Not wanting toeat

Low fever

Nausea and sometimes vomiting

Diarrheaor constipation

Treatment Options

Surgery

Laparoscopic appendectomy-the appendix is removed with instruments placed into small abdominal incising.open appendectomy-the appendix is removed through an incision in the lower right abdomen.

Common Diagnostic Tests

History and Physical

The focus will be on your abdominal pain.There is no single test to confirm appendicitis.

Nonsurgical

Surgery is the standard treatment for an acute(sudden) infection of the appendix.Antibiotic treatment might be used as an alternative for specific patients and children.

Benefits and Risks

Anappendectomy will remove the infected organ and relieve pain.Once the appendix is removed, appendicitis will not happen again.The risk of not having surgery is the appendix can burst , resulting in an abdominal infection called peritonitis.Possible complication sin include abscess, infection of the wound or abdomen, intestinal blockage, hernia at the incision, pneumonia, risk of premature delivery (if you are pregnant), and death.

Expectations

Befor a your operation—

Evaluation usually includes blood work,urinalysis,and an abdominal CT scan,orab dominal altrasound. Your surgeon and anesthesia provider will review your health history, medications, and options for pain control. The day of your operation—You will not be allowed to eat or drink while you are being valued for an emergency appendectomy. Your recovery—If you have no complications, you usually can go home in 1 or 2 days after a laparoscopic or open procedure.Call your surgeon if you are in severe pain, have stomach cramping, a high fever, odor or increased drainage from your incision, or no bowel movements for 3days.

The Condition,Signs and Symptoms,and Diagnostic Tests

The Condition

The Appendix

The appendix is a small pouch that hangs from the large in test in where the small and large in test in join. If the appendix becomes blocked and swollen, bacteria can grow in the pouch.The blocked opening can be from an illness, thick mucus, hard stool, or a tumor.

Appendicitis

Appendicitis infection of the appendix.The infection and swelling can decrease the blood supply to the wall of the appendix.This lead stot issue death/, and the appendix can rupture or burst, causing bacteria and stool to release into the abdomen.This is called a ruptured appendix.A ruptured appendix can lead to periton it is, which is an infection of your entire abdomen.Appendicitis most often affects people between the age so f10 and 30 years old.It is a common area son for a no operation in children, and it is the most common surgical emergency in pregnancy.

Symptoms?

Stomach pain that usually start saround the naveland then moves to the lower right side of the abdomen.

Loss of appetite

Low fever,usually be low 100.3°F

Nausea and sometimes vomiting

Diarrheaor constipation

Common Diagnostic Tests

History and Physical

The focus will be onyourabdominal pain.There is no single test to confirm appendicitis.

Tests(seeglossary)

Abdomin altrasound—Checks for anen larged appendix Complete blood count(CBC)—A blood test to check for infection Rectalexam—Checks for tendernesson the right side and for anyrectal problems that could be causing the abdominal pain Pelvicexam—May be done in young women to check for pain from gynecological problems like pelvic inflammationor infection Urinalysis—Checks for an infection in your urine,which cancaus eabdominalpain Electro cardiogram(ECG)—Some times done in the old eradultto make sure heart problems are not the causeofpain

Keeping You Informed

Appendicitis Pain

Pain can be different for each person because the appendix can touch different organs. This can be confusing and make it difficult to diagnose appendicitis. Most often pain starts around the navel and then moves to the right lower abdomen. The pain is often worse with walking or talking. During pregnancy, the appendix sits higher in the abdomen, so the pain may seem to come from the upper abdomen. In the elderly, symptoms are often not as noticeable because there is less swelling

The Surgical and Nonsurgical Treatment

Surgical Treatment

Acute appendicitis is an urgent problem requiring surgical consultation.

Laparoscopic Appendectomy

This technique is the most common for simple appendicitis. The surgeon will make 1 to 3 small incisions in the abdomen. A port (nozzle) is inserted into one of the slits, and carbon dioxide gas inflates the abdomen. This process allows the surgeon to see the appendix more easily. A laparoscope is inserted through another port. It looks like a telescope with a light and camera on the end so the surgeon can see inside the abdomen. Surgical instruments are placed in the other small openings and used to remove the appendix. The area is washed with sterile fluid to decrease the risk of further infection. The carbon dioxide comes out through the slits, and then the sites are closed with sutures or staples or covered with glue-like bandage and Steri-Strips. Your surgeon may start with a laparoscopic technique and need to change to an open technique. This change is done for your safety

Open Appendectomy

The surgeon makes an incision about 2 to 4 inches long in the lower right side of the abdomen. The appendix is removed from the intestine. The area is washed with sterile fluid to decrease the risk of further infection. A small drainage tube may be placed going from the inside to the outside of the abdomen. The drain is usually removed in the hospital. The wound is closed with absorbable sutures and covered with glue like bandage or sterile-stripes.

Nonsurgical Treatment

If you only have some of the signs of appendicitis, your surgeon may treat you with antibiotics and watch for improvement. In an uncomplicated appendectomy, antibiotics may be effective, but there is a higher chance of reoccurrence.

Keeping You Informed

Laparoscopic versus Open

For both adults and children, laparoscopic appendectomy has an advantage of lower infection rate, shorter hospital and recovery time, and lower pain scores. There was a slightly increased risk of infection of the urinary tract and within the abdomen (abdominal abscess) and bleeding within the abdomen.

Ruptured Appendix

Unfortunately, many people do not know they have appendicitis until the appendix bursts. If this happens, it causes more serious problems. The incidence of ruptured appendix is 270 per 1,000 patients. This is higher in the very young and very old and also higher during pregnancy because the symptoms (nausea, vomiting, right-sided pain) may be similar to other pregnancy conditions




Expectations: Preparing for Your Operation

Preparing for Your Operation

Home Medication

Appendectomy is usually an emergency procedure. You can help prepare for your operation by telling your surgeon about other medical problems and medications that you are taking.

Be sure to tell your surgeon if you are taking blood thinners (Plavix, Coumadin, aspirin).

Anesthesia

You will meet with your anesthesia provider before the operation. Let him or she knows if you have allergies, neurologic disease (epilepsy or stroke), heart disease, stomach problems, lung disease (asthma, emphysema), endocrine disease (diabetes, thyroid conditions), loose teeth, or if you smoke, drink alcohol, use drugs, or take any herbs or vitamins. Let your surgical team know if you smoke and plan to quit. Quitting decreases your complication rate

Lenght of stay

You can often go home in 1 or 2 days. Your the hospital stay may be longer for a ruptured appendix.

Don't at or drink

You will not be allowed to eat or drink while you are being evaluated for an appendectomy. Not eating or drinking reduces your risk of complications from Anesthesia

What to bring

Insurance card and identification

Advance directive (see glossary)

List of medicines

Loose-fitting, comfortable clothes

Leave jewelry and valuables at home

What You Can Expect

Safety Checks

An identification (ID) bracelet and allergy bracelet with your name and hospital/clinic number will be placed on your wrist. These should be checked by all health team members before they perform any procedures or give you medication. Your surgeon will mark and initial the operation site.

Fluids and Anesthesia

An intravenous line (IV) will be started to give you fluids and medication. For general anesthesia, you will be asleep and pain free during the operation. A tube may be placed down your throat to help you breathe during the operation

After Your Operation

You will be moved to a recovery room where your heart rate, breathing rate, oxygen saturation, blood pressure, and urine output will be closely watched. Be sure that all visitors wash their hands

Preventing Pneumonia and Blood Clots

Movement and deep breathing after your operation can help prevent postoperative complications such as blood clots, fluid in your lungs, and pneumonia. Every hour, take 5 to 10 deep breaths and hold each breath for 3 to 5 seconds.

When you have an operation, you are at risk of getting blood clots because of not moving during anesthesia. The longer and more complicated your surgery, the greater the risk. This risk is decreased by getting up and walking 5 to 6 times per day, wearing special support stockings or compression boots on your legs, and for high-risk patients, taking a medication that thins your blood.

Questions to Ask


About My Operation:

What are the side effects and risks of anesthesia?

What technique will be used to remove my appendix? Laparoscopic or open?

What are the risks of this procedure for me?

Will you be performing the entire operation yourself?

What level of pain should I expect, and how will it be managed?

How long will it be before I can return to my normal activities (work, driving, lifting)?

Your Recovery and Discharge

Your Recovery and Discharge

Thinking Clearly

The anesthesia may cause you to feel diff erent for 1 or 2 days. Do not drive, drink alcohol, or make any big decisions for at least 2 days

Nutrition

When you wake up, you will be able to drink small amounts of liquid. If you do not feel sick, you can begin eating regular foods.

Continue to drink lots of fl uids, usually about 8 to 10 glasses per day.

Eat a high-fi ber diet so you don’t strain during bowel movements

Activity

Slowly increase your activity. Be sure to get up and walk every hour or so to prevent blood clots.

ContDo not lift or participate in strenuous activity for 3 to 5 days for laparoscopic and 10 to 14 days for open procedure.

You may go home in 1 to 2 days for a laparoscopic repair. If your appendix ruptured or you have other health issues or complications, you may stay longer.

It is normal to feel tired. You may need more sleep than usual.

Work and Return to School

You can go back to work when you feel well enough. Discuss the timing with your surgeon.

Children can usually go to school 1 week or less after an operation for an unruptured appendix and up to 2 weeks after a ruptured appendix.

Most children will not return to gym class, sports, and climbing games for 2 to 4 weeks after the operation

Bowel Movements

After intestinal surgery, you may have loose watery stools for several days. If watery diarrhea lasts longer than 3 days, contact your surgeon.

Pain medication (narcotics) can cause constipation. Increase the fi ber in your diet with high-fi ber foods if you are constipated. Your surgeon may also give you a prescription for a stool softener.

Pain

The amount of pain is different for each person. Some people need only 1 to 3 doses of pain control medication, while others need more.

Home Medications

The medicine you need after your operation is usually related to pain control.

Wound Care

Always wash your hands before and after touching near your incision site.

Do not soak in a bathtub until your stitches or Steri-Strips are removed. You may take a shower after the second postoperative day unless you are told not to.

Always wash your hands before and after touching near your incision site.

Do not soak in a bathtub until your stitches or Steri-Strips are removed. You may take a shower after the second postoperative day unless you are told not to.

Follow your surgeon’s instructions on when to change your bandages.

A small amount of drainage from the incision is normal. If the drainage is thick and yellow or the site is red, you may have an infection, so call your surgeon.

If you have a drain in one of your incisions, it will be taken out when the drainage stops.

Steri-Strips will fall off in 7 to 10 days or they will be removed during your fi rst offi ce visit.

If you have a glue-like covering over the incision, allow the glue to fl ake off on its own.

Avoid wearing tight or rough clothing. It may rub your incisions and make it harder for them to heal.

Protect the new skin, especially from the sun. The sun can burn and cause darker scarring.

Your scar will heal in about 4 to 6 weeks and will become softer and continue to fade over the next year.

Sensation around your incision will return in a few weeks or months.