Appendectomy

Appendectomy is the surgical removal of the appendix, a small pouch attached to the beginning of the large intestine. It is most commonly performed to treat acute appendicitis, an inflammatory condition that can lead to perforation if not removed. The procedure may also be performed for suspected appendiceal tumors or as an incidental operation during other abdominal surgery.

Most modern appendectomies are performed laparoscopically, using several small abdominal incisions and a camera to guide the operation. This approach often allows quicker recovery and fewer wound complications. If laparoscopic access is not feasible or if complications arise, an open appendectomy through a right lower abdominal incision may be performed, sometimes after converting from laparoscopy.

Preoperative evaluation includes history, examination, and imaging such as ultrasound or computed tomography to confirm appendicitis. Perioperative antibiotics are routinely given to reduce infection risk, and anesthesia is usually general.

Recovery is typically faster after laparoscopic surgery, with many patients discharged within 1–2 days. Return to normal activities generally occurs within 1–3 weeks for open procedures and 1–2 weeks for laparoscopic ones, depending on pain, infection, and other factors.

Common complications include wound infection, intra-abdominal abscess, ileus, and, rarely, injury to surrounding organs. A negative appendectomy—removal of a noninflamed appendix—can occur. The excised tissue is sent to pathology to confirm appendicitis and to rule out other diseases such as neoplasms.

In selected cases of uncomplicated acute appendicitis, nonoperative management with antibiotics may be attempted, with interval appendectomy considered if symptoms recur or imaging suggests persistent inflammation.