Laparoscopic(key hole)removal of appendix with acute presentation of acute abdomen.
The information here is a guide only and does not replace my discussions with you on the day of consultation.
What causes appendicitis?
It is believed to be caused by blockage between the junction of appendix to the large bowel.
The blockage can be due to faecal matter, parasites ,inflammation of bowel, and not commonly cancer of the base of appendix. This prevents the mucus from leaving the appendix and swelling of the appendix and eventually if left untreated weakening of the appendix wall and rupture with the potentially life threatening blood poisoning.
What symptoms should I expect from Appendicitis?
The symptoms of appendicitis can vary from one person to another but common symptoms are:
Vague tummy pain which moves to the right lower side of the tummy, loss of appetite, nausea, and fever.
What can be done about the Appendicitis?
Generally the advice is to have appendix removed with surgery.
You might think why not to give antibiotics only since this can settle infection: There would be no guarantee that it doesn’t come back or it may get worse or rupture. The other important issue in not missing an uncommonly found cancer.
How do I remove the appendix?
You will be advised to fast prior to the procedure, and the updated details will be given to you from my rooms or nursing team depending on timing of procedure.This is done under general anaesthesia by Key-hole surgery. Once you are fully sleep the instruments will be inserted through small holes in the tummy which includes a fibreoptic telescope and two other long instruments and the appendix is removed. Special suture will be used to disconnect the appendix from the large bowel.
What happens after surgery?
-Most patients who undergo appendix surgery will stay overnight.
-You will be given regular simple pain relief medications. Examples include Panadol and Nurofen. Sometimes you require stronger pain relief and this be prescribed in your medication chart.
-Your wound will be checked by nursing staff and will be given medications to prevent clot formation in legs together with white stockings(this will also reduce the risk of clot formation).Your heart rate, breathing rate, Blood pressure and temperature and your blood oxygen levels will be checked regularly.
-You might notice there is a soft plastic drain tube in you tummy. This is usually removed depending on the amount of fluid drainage in one to 2 days time.
-You generally can have normal diet and there are no restrictions after anaesthesia
-You may experience having trouble passing urine, and the nursing staff will need to be notified. At times if simple measures don’t help some patients require temporary urinary catheter.
-You will be given a device to help with breathing after surgery if you have underlying lung problem or if having trouble breathing well.
-If you require strong pain relief this may cause constipation so you might need over the counter laxatives if simple measure don’t work.
-Try to do light activity shortly after surgery.
-The dressing that we use is waterproof and you can have shower with them and you can remove them after a week.
-The sutures that are used for skin closure are absorbed and there is no need to remove sutures.
-You should not drive for a week after the operation and avoid lifting heavy items for at least 6 weeks after surgery.A medical certificate will be provided if required.
-Most patients feel a hard ridge under the wound and this generally will disappear after few months.
-There is small risk that the wound can become red and sore and discharge fluid. If you are worried please don’t hesitate to call my rooms for earlier review.
What are the risks of appendix surgery?
There are general and specific risks to surgery:
-Heart problems, clots in legs, stroke especially if there are pre-existing serious medical conditions before surgery.
-Gas bubble into the blood, Wound infection, raised, irregular scar. Few people develops these since most cuts heal well.
- Injury to organs/nerves/blood vessels near the appendix. Rarely
-Bowel blockage due to scarring or hernia. Uncommon
-Death due to this procedure is extremely rare
-Re-operation if there is the bleeding or bowel leakage
What costs to be incurred from this practice?
There will be an out of pocket charge for your procedure from my service.When you present to my rooms for consultation, this is not covered by your private health funds. You will get some of the money for outpatient consultations back from Medicare.
There may be an out pocket expenses for anaesthetic services depending on your level of cover.Please contact Downs anaesthetics for further details.
You should ask them ahead of time about this cost. You will also have to pay any hospital excesses that your policy dictates. We will provide you with contact details after consultation so you could check ahead of time.