Mini Laparoscopic appendicectomy.
Appendicitis is one of the more common surgical problems. One in two thousand persons has had an appendicectomy in some moment of life.
INFORMATION FOR THE PATIENT FROM HIS (HER) SURGEON AND SAGES
WHAT IS THE APPENDIX?
The appendix produces a destructive protein of bacterias which is called inmunoglobulin that helps to fight against the infection of the organism. However, its function is not essential. People who have had an appendicectomy do not have an increased risk to suffer an infection. Other organs of the body accepts such function when removing the appendix.
WHAT IS A LAPAROSCOPIC APPENDICECTOMY?
Appendicitis is one of the more common surgical problems. One in two thousand persons has had an appendicectomy in some moment of life. A surgery is required to remove the infected appendix. The traditional way is that the appendix is removed through an incision in the right lower abdominal wall.
In most of the laparoscopic appendicectomies surgeons operate through three smal incisions (each one measures between 6 and 12,5 mm approximately) while observing an enlarged image of the inner organs of the patient in a television screen. In some cases, one of the small openings can be enlarged until measuring 5 to 7,5 cm in order to complete de procedure.
ADVANTAGES OF THE LAPAROSCOPIC APPENDICECTOMY
Results may vary according to the procedure that is used and the general condition of the patient.
The common advantages are:
- Less postoperative pain
- Shortens the hospital staying.
- It can turn out in a faster return to the intestinal function.
- A faster return to normal activity
- Better cosmetic results.
ARE YOU A CANDIDATE FOR A LAPAROSCOPIC APPENDICECTOMY?
Even the laparoscopic appendicectomy brings many benefits, it is possible that is not suitable for some patients. A non perforated appendix that is diagnosed in an early way can generally be removed by laparoscopic means. A laparoscopic appendicectomy is more difficult to perform if there is a severe infection or if the appendix is perforated. It is possible that in said patients an open-pit procedure may be necessary, in which a bigger incision is used, so that the infected appendix is safely removed.
HOW IS THE LAPAROSCOPIC APPENDICECTOMY PERFORMED?
The words “laparoscopic” appendicectomy and “open-pit” describe the techniques that a surgeon uses to access to an inner surgical field.
In most cases the laparoscopic appendicectomies begin in the same way. By means of a cannula (a narrow and tubular instrument), the surgeon accesses to the abdomen. A laparoscop (a small telescope connected to a video camera) is inserted through a cannula, wich offers the surgeon an amplified wide view of the patient’s inner organs in a television screen. Many additional cannulas are inserted in order to let the surgeon working inwardly and to remove the appendix. The whole procedure can be completed through cannulas or by extending one of the small incisions for the cannulas. It is possible that a drainage is set during the procedure. It will be removed before your leaving the hospital.
WHAT HAPPENS IF THE SURGERY CANNOT BE PERFORMED OR BE COMPLETED BY LAPAROSCOPIC MEANS?
In a small amount of patients the laparoscopic method cannot be feasible due to the impossibility of visualizing or manupilating the organs in an effective way. When the surgeon feels that is safer to turn the laparoscopic procedure into an open one it is not because a complication, but a sensible surgical decision. Among the factors that can increase the possibility that the procedures turns it into an “open-pit” can include:
Severe infection / or an abcess
A perforated appendix
Obesity
History of a prior abdominal surgery that caused a dense scar tissue
Impossibility of visualizing the organs.
Bleeding problems during the surgery.
The decision of performing an open-pit procedure is determined by the criteria of the surgeon, either before or during the surgery itself. The decision of turning it into an opern procedure is exclusivelly based on the patient’s safety.
WHAT TO EXPECT AFTER THE SURGERY?
After the surgery it is importante that the patient follows the instructions of his(her) doctor. Although some persons fell better after few days, remember that your organism needs time to heal.
The patient is encouraged to get up from bed the day after the surgery and to walk. This will help him(her) to decrease his(her) muscle pain, and also the risk of the clot formation in his(her) legs.
It is probably that the patient can return to his (her) normal activities in one or two weeks. Activities such as: taking showers, driving his (her) car, climbing stairs, lifting up things, working or having intercourse are included.
If your pain is extended or if the prescribed pain relievers are not producing relief, the patient should inform his(her) doctor about it.
Call and ask for a medical control appointment before reaching the next two weeks after your surgery.
WHAT COMPLICATIONS MAY HAPPEN?
As in any surgery there are risks that include complications. However, the risks that such complications may occur are not bigger than those when performing the surgery by the open-pit technique.
Bleeding
Infection.
The loss of the colon edge where the appendix was removed.
Injury of adjacent organs such as small intestine, urethra and bladder.
A blood clot in the lungs.
It is important that you recognize the early signs of possible complications. Contact your surgeon if you notice severe abdominal pain, fever, shivers or rectal bleeding.
WHEN TO CALL YOUR DOCTOR
Be sure to call your doctor or surgeon if any of the following symptoms are presented:
Fever above 101°F (39°C) does not drop.
Bleeding.
Abdominal swelling or groin that goes up.
Pain that is not relieved with medications.
Nausea or persistent vomits
Shivers.
Persistent caughing or short of breath
Purulent drainage (pus) from any incision
Redness around any of the incisions that gets worst or gets bigger.
Impossibility to eat or to drink liquids.
This brochure does not pretend to replace the conversation with your surgeon over the necessity of getting an appendicectomy. If you have any question reffered to your necessity of getting an appendicectomy, its alternatives, the invoicing or the covering of the insurance, or about the training and experience of your surgeon, do not hesitate in asking such surgeon or the personnel of the clinic about it. If you have questions over the surgery or the subsequent control, we ask you to talk about such subjects with your surgeon before or after the surgery.
