appendectomies

An appendectomy is the surgical removal of the vermiform appendix, a narrow pouch attached to the start of the large intestine. It is most commonly performed to treat acute appendicitis, an inflammation of the appendix that can progress to rupture if untreated.

Indications include acute appendicitis, suspected perforation or abscess, appendiceal tumors, and, occasionally, incidental removal when the appendix is accessed during another abdominal operation. In selected cases of uncomplicated appendicitis, nonoperative management with antibiotics may be attempted as an alternative to immediate surgery, though surgery remains standard in many settings.

Two principal surgical approaches are used: open appendectomy and laparoscopic appendectomy. Open surgery uses a single small incision in the lower right abdomen; laparoscopic surgery uses several small incisions and a camera-assisted view. Laparoscopy often offers shorter hospital stay and faster recovery, but the choice depends on patient factors and surgeon experience. In both approaches, the surgeon identifies the appendix, ligates the mesoappendix, ties off the appendiceal base, and removes the organ; the peritoneal cavity may be irrigated if perforation or pus is present.

Preoperative assessment typically includes history, physical examination, laboratory tests, and imaging as needed. Antibiotic prophylaxis is commonly given before incision. Postoperative care emphasizes pain control, early mobilization, and diet advancement. The length of stay is usually shorter after laparoscopic procedures; full return to routine activities may take one to three weeks for uncomplicated cases.

Common complications include wound infection, intra-abdominal abscess, ileus, injury to bowel or bladder, and hernia at the incision site. The procedure has a long history in general surgery and is among the most common emergency operations worldwide.