Appendectomy

Appendectomy

An Appendectomy (or as it is also commonly named appendicectomy) is a surgical procedure through which the patient’s vermiform appendix is removed from his or her organism. Typically, this procedure is performed as an emergency surgery in the case of patients that are suffering from acute appendicitis, however it is common practice that the appendix is removed during other abdominal surgical procedures as a prophylactic measure to help prevent additional surgical interventions in the future. Appendicitis is caused by an inflammation of the appendix, and is characterized by pain in the abdomen, which localizes in the lower right part, fever, nausea and vomiting, as well as a loss of appetite. In case the patient is suffering from acute appendicitis and the surgical facilities are not readily available, administration of intravenous antibiotics is recommended in order to avoid or at least delay the onset of sepsis. Often, many cases may also be completely resolved without having to resort to surgery. However, if left untreated this condition causes a high mortality rate, mainly due to peritonitis and other complications.

In most cases, the patients recover from appendicitis and from the Appendectomy completely, without any adverse reactions or side effects. However, studies have shown that such adverse reactions are possible in a relatively low number of cases, and their severity ranges from mild to complex, possibly life-threatening. As such, after undergoing such a surgical intervention, the patient is to be kept under close monitoring for the entire recovery period in order to detect any early signs of complications and to intervene as necessary.

A more complex case of Appendectomy is encountered in patients who present a ruptured appendix. This situation is a medical emergency and may often lead to the death of the patient if left untreated for too long. Health care personnel should be able to recognize this situation immediately and promptly take the necessary measures to ensure the patient’s safety, treatment and recovery.

Appendectomy Description

There are two types of Appendectomy surgical operations. One of these is the standard open surgery method, while the other is a laparoscopic procedure devised as part of the minimally invasive type of surgery. Laparoscopic surgery is often performed if the diagnosis is not certain, or if the patient wishes to hide the scars, either in the pubic hair line or the umbilicus. Generally, the patient recovers faster after a laparoscopic procedure is performed; however the procedure is more resource intensive and as such, more expensive. Also, a laparoscopic procedure takes longer than open surgery and presents a small risk for pneumoperitoneum (a gas inflation of the abdomen). In the case of advanced pelvic sepsis, a lower midline laparotomy is occasionally required.

Typically, an Appendectomy is preceded by administration of antibiotics if any signs of sepsis are present. Even if the patient presents no signs of sepsis, it is recommended that he or she is administered a prophylactic dose of intravenous antibiotics prior to the surgical operation. The patient is then administered anesthetics inducing general anesthesia, and full muscle relaxation is induced prior to applying endotracheal intubation. The abdomen is draped, prepared and examined, and if a mass is present, the incision must be made over the mass. Otherwise, the surgeon will perform the incision between the umbilicus and the anterior superior iliac spine, over McBurney’s point. This represents the position of the appendix base. The abdominal wall layers are opened, with concern to preserving their integrity, and the surgeon must pass through the internal oblique muscle by slitting along its length, while also splitting the external oblique aponeurosis along its fiber, to prevent future incisional hernia. Once the peritoneum has been entered, the appendix is easily identified. It can now be mobilized and ligated, then severed at its base. The stump of the appendix may be left on the outside of the caecum, or it may be inverted and buried in the caecum. Once these operations are completed, the abdominal wall layers are closed. In most cases, the Appendectomy operation is successful and after a short recovery period the patient may resume normal activity.

Appendectomy Related Medication

A patient who is scheduled to undergo this type of medical procedure (Appendectomy) might have to undergo a therapy course with special drugs called beta-lactamase inhibitors. Such medication can be referred to under the generic name of Tazobactam / Piperacillin. One of the most common clinical remedies that belong to this class is Zosyn, a drug that is prescribed to numerous patients who are about to undergo an Appendectomy. Depending on the patient’s current health care condition and on his or her PD’s professional expertise concerning this matter, the individual will have to use this type of medication either before or after his undergoing the Appendectomy surgery; in some cases, patients have had to use Zosyn both before and after the surgical procedure.

Drugs like Zosyn are effective in fighting against harmful pathogens (bacteria) inside the patient’s organism. The use of similar drugs has helped numerous patients who were suffering from several types of infectious conditions (including pneumonia, skin infections, stomach infections, joint infections, bone infections, urinary tract infections, etc). You probably already figured out that a therapy course with Zosyn in the case of patients who are to undergo or who have already undergone Appendectomy has a prophylactic purpose: it aims to prevent that individual from experiencing one of the most severe complications of this medical procedure: infection. A therapy course with an antibiotic is taken into consideration especially in the case of patients who have recently undergone a therapy course with an immunosuppressant product.

Unfortunately, not all patients are allowed to use this type of medical remedy. For example, the use of Zosyn is contra-indicated in the case of individuals who are on dialysis or who suffer from a certain type of kidney medical condition, a blood clotting disorder (a bleeding condition), cystic fibrosis, electrolyte imbalance, history of allergies to similar medication, and so on. Furthermore, patients who are currently on a salt-restricted diet should employ extra caution during their therapy course with such a medication.