What is Appendicectomy?
An appendicectomy is the surgical procedure to remove the appendix, a small tube located in the lower right side of the abdomen. (In USA it is called Appendectomy).
The appendix can become inflamed, a condition known as appendicitis, which typically requires surgery to prevent serious complications. In most cases, appendicitis needs to be treated with an appendectomy to remove the infected appendix and prevent it from rupturing.
There are two main types of appendectomy:
- Laparoscopic (Keyhole) Surgery: This is the most common procedure. It involves making three small cuts in your child’s abdomen and using a tiny camera and instruments to remove the appendix.
- Open Surgery: In some cases, a larger incision is required. This is usually performed in infants if the appendix has already ruptured or if there are complications during the keyhole procedure.
There is new evidence that treating early appendicitis (before it ruptures) with antibiotics may avoid surgery in some cases. Your surgeon will discuss this with you.
Preparing for Surgery
Before the surgery, your child will be given antibiotics to help stop the infection from worsening. The surgeon, anaesthetist, and nursing staff will explain the procedure and answer any questions you may have.
During the surgery, your child will be put to sleep under general anaesthesia, meaning they won’t feel anything during the operation.
How Long Does an Appendicectomy Take?
Surgery typically takes around 30-60 minutes, depending on how bad the appendicitis is.
After the surgery, your child will be taken to the recovery room, where you will be called to be with them as they wake up from anaesthesia.
After the Appendicectomy
Once the operation is complete, your child may feel groggy or nauseous due to the effects of anaesthesia. They will receive fluids and medications through an intravenous (IV) drip, including pain relief and antibiotics to prevent infection.
- Pain Relief: Most children will need pain medication for the first few days after surgery. Paracetamol or ibuprofen is often recommended. Your healthcare team will guide you on the best way to manage your child’s pain.
- Antibiotics: These will be given via the IV drip to reduce the risk of wound infection after the operation.
In more severe cases, like ruptured (perforated) appendicitis there are additional supportive measures required for your child.
- Catheter: If the appendicitis was bad (ruptured) a urinary catheter may be placed to help with fluid monitoring, and comfort so they don’t have to get up to go to the toile
- Nasogastric tube: This is a tube that is placed in the nose, that helps empty the stomach. It is a good way of avoiding the vomiting that can occur after the operation.
- Long intravenous line: Sometimes the gut won’t work quickly, so we need to provide nutrition directly into the veins. These are special tubes that can access the veins, which last much longer than the usual intravenous cannulas.
Recovery in the Hospital
The length of your child’s hospital stay will depend on the severity of the appendicitis and the type of surgery performed.
For uncomplicated appendicitis, most children can go home within 1-2 days after surgery.
If the appendix has burst or there are complications, your child may need to stay in the hospital for several days, typically between 3-5 days, to allow for recovery and monitoring.
Eating and Drinking After Surgery
Your child will likely feel nauseous and may not want to eat right after surgery. Fluids will be given through the IV drip until they are ready to eat and drink again, typically around 4-6 hours after the operation.
Once cleared to eat, your child will begin with small amounts of food and drink, and their diet will gradually return to normal as they feel better. Always follow the instructions of the medical team regarding food and drink intake post-surgery.
Caring for the Wound and Dressings after Appendectomy
Your child’s stitches will be dissolvable, and any dressings used to cover the surgical wounds will need to be removed after about a week. You’ll be given instructions on how to care for the wounds and when your child can bathe or shower.
Pain Relief after Appendectomy
You can continue to give your child paracetamol or ibuprofen as needed for pain. If the pain becomes worse or doesn’t improve, contact your doctor.
Normal Activity after Surgery
Bath or shower: the day after surgery
Daycare or School: After approximately one week
Sports or Physical Activity: Avoid sports or strenuous activities for at least two weeks
When to Seek Medical Attention
After surgery, it’s important to keep an eye on your child’s recovery and be aware of any potential complications. Seek medical advice if your child experiences any of the following:
- Fever: A persistent fever above 38.5°C could indicate infection.
- Wound Infection: Look for signs of redness, swelling, discharge, or increased pain around the wound site.
- Severe Pain: If your child’s pain is not controlled by medication or is getting worse, it’s important to seek medical attention.
- Other Symptoms: If your child has vomiting, difficulty eating, or has not had a bowel movement after three days, contact your doctor or surgeon.
Follow-Up Appointments
Your child will need a follow-up appointment with the surgeon after the appendectomy. This is usually scheduled for 1-2 weeks after the surgery to check on the wound healing and ensure there are no complications.
