Laparoscopic appendectomy is a procedure for removing an infected appendix (appendectomy) using the laparoscopic method. Laparoscopic appendectomy is an alternative method of open surgery of the appendix.
The appendix is a 5–10 cm long organ with a sac-like shape attached to the large intestine. The function of the appendix is not known with certainty, but this organ is believed to help the body in dealing with diarrhea, inflammation, and infections in the small intestine and large intestine.
The appendix can become inflamed or infected. This condition is known as appendicitis. If appendicitis is not treated promptly, the appendix can rupture and allow bacteria to enter the abdominal cavity. This can lead to a serious condition called peritonitis.
The method of treating appendicitis is appendectomy or surgical removal of the appendix. Appendectomy can be performed with an open surgical technique or a laparoscopic technique. Laparoscopy itself is done using a laparoscope, which is a tool in the form of a long tube equipped with a camera and a light at the end.
Appendectomy with the laparoscopic method has several advantages compared to the open surgical method, namely:
- Less pain after surgery
- Less risk of infection
- Faster recovery time
- Smaller scars
Indications for Laparoscopic Appendectomy
As previously explained, there are two surgical methods for treating appendicitis, namely open surgery and laparoscopic appendectomy. From these two options, the doctor will choose the right surgical method and according to the patient's condition.
Laparoscopic appendectomy is usually performed on appendicitis patients who are pregnant, overweight, elderly, or still young.
Contraindications to laparoscopic appendectomy
Although it has a number of advantages over open surgery, laparoscopic appendectomy is not recommended in a number of conditions. Doctors may advise patients to undergo open surgery if they have the following conditions:
- The patient's condition is unstable
- There has been generalized peritonitis
- There is a tear in the appendix
- Have a history of heavy bleeding at surgery
- There is scar tissue (scar) from previous abdominal surgery
- Suffering from morbid obesity
Appendix Surgery Warning with Laparoscopy
For those of you who are planning to undergo laparoscopic appendectomy, there are several things that must be considered, namely:
- Tell your doctor if you have a history of allergies to any of the ingredients in anesthetic drugs.
- Tell your doctor if you have diabetes, heart disease, lung disease, kidney disease, stroke, or have a history of blood clotting disorders.
- Tell your doctor if you smoke, drink alcohol, or abuse drugs.
- Tell your doctor about any medications, supplements, vitamins, and herbal products you are currently taking, especially if you are taking blood-thinning medications.
- Tell your doctor if you are pregnant.
Before Appendectomy with Laparoscopy
Before surgery, the doctor will make some preparations first. Preparations that will be made include:
- Asking the patient's thorough medical history, such as history of allergies, previous surgery history, and what medicines or herbal products are currently being consumed
- Do a physical examination
- Carry out supporting examinations, such as blood tests or imaging tests, depending on the patient's condition
In addition, there are several things that patients need to prepare and do before undergoing laparoscopic appendectomy, namely:
- Fasting for about 8 hours
- Inviting family or colleagues to accompany and take them home, because the effects of anesthetic drugs do not allow patients to drive their own vehicles
- Wear loose and comfortable clothing, and wear sandals or shoes that can be removed without bending over, on the day of surgery
- Don't wear jewelry, and don't wear make-up and nail polish
- Changing the clothes worn with a surgical gown
Before the operation begins, the doctor will explain various things related to the surgical procedure and the risks that may occur. After the patient understands the things that have been explained, the doctor or nurse will provide a statement to be signed.
Other things the doctor will do before performing this procedure are:
- Give antibiotics to reduce the risk of peritonitis, intestinal perforation (tear), and pain due to inflammation that can occur during surgery
- Provide fluids and drugs to prevent nausea and vomiting through an IV
After the preparations are completed and the doctor ensures the patient's condition is stable, the patient will be taken to the operating room.
Appendix Surgery Procedure with Laparoscopy
The laparoscopic appendectomy procedure generally takes approximately 1 hour. The following are the steps performed by doctors in laparoscopic appendectomy:
- Ask the patient to lie on the operating table in a supine position
- Shaving hair in the incision area will be made
- Putting an IV tube in the patient's arm to deliver drugs and fluids
- Injecting general anesthesia through an IV, so that the patient sleeps during the procedure
- Make 1–3 small incisions around the navel, as access to the tool to be used
- Inserting a small tube into one of the incisions that have been made to deliver carbon dioxide gas, so that the patient's abdomen is expanded and the abdominal organs are more clearly visible
- Insert the laparoscope through another incision and examine the condition of the abdominal organs
- Direct the laparoscope to the appendix, evaluate the condition of the appendix, and make preparations for excision of the appendix
- Tie the appendix with the help of other surgical instruments, then cut and remove it
- Removes carbon dioxide gas, laparoscopes, and other surgical instruments used in this procedure after the appendix is removed
- Cover the incision with sutures or surgical staples, then cover it with a surgical bandage or plaster
After Appendectomy with Laparoscopy
After the operation is complete, the patient will be taken to the recovery room. In this room, the doctor will monitor the patient's vital signs, including the patient's blood pressure, heart rate, and respiratory rate. The appendix that has been removed will be taken to a laboratory for analysis.
If the patient's condition is stable, the doctor can allow the patient to go home after surgery. However, in some cases, the doctor will recommend that the patient undergo hospitalization in the hospital.
After surgery, there are some complaints that may be experienced by the patient. However, these complaints are normal and will disappear in a few days. Some of these complaints are:
- Nausea and bloating
- Pain in the area of the incision
- Pain in the shoulder or neck
- Sore throat
- Cramps in the stomach
Please note, the length of recovery time can be different for each patient. It depends on the overall condition of the patient and the reaction of the patient's body to the operation.
During the recovery period, patients are required to take medicines prescribed by doctors, such as antibiotics and pain relievers. Patients should also do the following things to speed up the healing process:
- Get enough rest
- Keep the surgical wound clean and dry
- Keep moving, for example by walking leisurely for 10-15 minutes, 4-5 times a day
- Drink warm water to relieve bloating
- Avoid strenuous activities, such as lifting heavy weights, for at least 3-5 days
- Wash hands before and after touching the surgical area
- Wear loose, soft clothes
- Carry out the examination according to the schedule determined by the doctor
Patients who have undergone laparoscopic appendectomy generally recover in 1–2 weeks. However, to reduce the risk of complications, ask your doctor when is the right time to start activities.
Risks of Laparoscopic Appendectomy
Every surgical procedure has risks, as does laparoscopic appendectomy. Some of the risks that may arise after undergoing this procedure are:
- Surgical wound infection
- Injuries to organs around the surgical area, such as the small intestine, urinary tract, and bladder
Immediately go to the nearest doctor or hospital if you experience the following complaints:
- Cough that doesn't go away
- Hard to breathe
- Very bloated stomach or unbearable pain
- Redness, swelling, or bleeding at the incision site
- Nausea or vomiting continuously
- Unable to urinate until 8–10 hours after surgery
- Diarrhea or constipation (constipation) for more than 3 days
- Discharge of pus from the incision area
- Bleeding from the anus