Appendicectomy, also known as appendectomy, is the surgical removal of the appendix — a small, tube-like organ attached to the large intestine. Though its exact function in the human body remains somewhat unclear, the appendix is known to play a minor role in immunity. However, it is not essential for survival. When it becomes inflamed or infected, a condition called appendicitis, surgery to remove the appendix often becomes urgently necessary, particularly when appendicectomy surgery is necessary.
Appendicectomy is one of the most commonly performed emergency surgeries worldwide. It can be a lifesaving procedure when done on time, especially in cases of complications like rupture or abscess formation.
Understanding the Appendix
The appendix is a narrow pouch, about 4 to 6 inches long, located in the lower right side of the abdomen. It arises from the cecum, which is the beginning portion of the large intestine. For decades, the appendix was considered a vestigial organ — a remnant from evolution with no significant function. However, newer studies suggest it may help maintain gut flora or act as a storehouse for beneficial bacteria. Despite this potential role, people can live healthy lives without it.
What Is Appendicitis?
Appendicitis occurs when the appendix becomes inflamed, typically due to a blockage. This blockage may result from hardened stool (fecalith), lymphatic tissue swelling, foreign objects, or infection. When the appendix is blocked, bacteria multiply rapidly, leading to swelling, pain, and sometimes pus formation. If left untreated, the appendix can burst, causing infection to spread throughout the abdominal cavity — a life-threatening condition known as peritonitis.
The most common symptoms of appendicitis include:
- Sudden pain in the lower right abdomen
- Nausea and vomiting
- Loss of appetite
- Fever
- Abdominal swelling
- Inability to pass gas
- Pain that worsens with movement, coughing, or sneezing
Not everyone experiences textbook symptoms, and sometimes the pain begins around the navel before moving to the lower right side. This variability makes diagnosis challenging in some patients, particularly children and the elderly.
When Appendicectomy Surgery is Necessary
Acute Appendicitis
The most common reason for appendicectomy is acute appendicitis — a sudden inflammation of the appendix. This is a medical emergency. If not treated promptly, the appendix may rupture within 24 to 72 hours after the onset of symptoms.
In cases of uncomplicated acute appendicitis, surgery is the standard treatment. In some mild cases, particularly where the diagnosis is uncertain or symptoms are improving, doctors may attempt antibiotic therapy. However, surgery remains the definitive solution, especially if there’s no rapid improvement or if symptoms worsen.
Complicated Appendicitis
When appendicitis progresses to more serious complications such as:
- Perforation (rupture)
- Abscess formation
- Peritonitis (infection of the abdominal cavity lining)
- Appendicular mass (a walled-off infection)
Surgery becomes even more urgent. In some cases with a large abscess, doctors may initially drain the abscess and postpone appendicectomy until the infection subsides — a strategy known as interval appendectomy.
Recurrent Appendicitis
Some patients experience repeated episodes of abdominal pain suggestive of inflammation in the appendix, referred to as chronic or recurrent appendicitis. Though rarer, these cases may warrant elective (planned) appendicectomy to prevent future complications.
Incidental Appendicectomy
During unrelated abdominal surgeries (like gynecological operations or bowel resections), surgeons may remove a normal-looking appendix as a preventive measure, particularly in young patients. This practice is called incidental appendectomy. It is less common today due to a more conservative surgical approach.
Diagnosis Before Surgery
Prompt diagnosis is crucial to prevent complications. The evaluation process usually involves:
- Physical Examination :- Palpation of the abdomen to locate pain and detect guarding or rebound tenderness
- Blood Tests :- To check for signs of infection (elevated white blood cell count)
- Ultrasound or CT Scan :- To confirm inflammation, detect fluid collections, or rule out other causes
- Urine Tests :- To exclude urinary tract infections or kidney stones
- Pregnancy Test :- To rule out ectopic pregnancy, which can mimic appendicitis
If appendicitis is confirmed or strongly suspected, surgery is typically scheduled immediately.
Types of Appendicectomy Procedures
There are two main types of appendicectomy procedures:
Laparoscopic Appendicectomy
In this minimally invasive technique:
- Three or four small incisions are made in the abdomen
- A camera (laparoscope) and instruments are inserted
- The appendix is identified, clipped, and removed
- The area is inspected for bleeding or infection
- Incisions are closed with sutures or glue
Advantages:
- Less post-operative pain
- Shorter hospital stay
- Faster recovery
- Smaller scars
Laparoscopic surgery is preferred when feasible, especially in early appendicitis cases or in women where diagnostic uncertainty exists.
Open Appendicectomy
In open surgery:
- A single, larger incision is made in the lower right abdomen
- The appendix is removed directly
- The abdominal cavity is cleaned if rupture has occurred
- The wound is closed, sometimes with drainage left in place
Open surgery is often necessary when:
- The appendix has ruptured
- There is a large abscess
- The patient has significant abdominal scarring from prior surgeries
What Happens After Surgery?
Hospital Stay
Most patients undergoing laparoscopic appendicectomy are discharged within 24–48 hours. Those who undergo open surgery or have complications may need a longer stay.
Recovery at Home
- Return to light activity within a few days
- Resume a normal diet gradually
- Avoid heavy lifting or strenuous exercise for 2 to 4 weeks
- Follow-up visit to check the incision and discuss pathology results (if the appendix was sent for testing)
Possible Risks and Complications
While appendicectomy is considered a safe procedure, complications can occur, including:
- Infection at the incision site
- Abscess formation in the abdomen
- Bleeding
- Bowel obstruction from scar tissue
- Hernia at the incision site (rare)
- Injury to surrounding organs
Complications are more likely when the appendix has already ruptured. Prompt surgery helps prevent these risks.
When to Seek Medical Attention After Surgery
Patients should contact their doctor if they experience:
- Persistent fever
- Increasing abdominal pain
- Redness, swelling, or discharge from the wound
- Nausea or vomiting
- Difficulty passing gas or stool
- Bleeding from the incision
These may be signs of infection or other complications needing immediate care.
Conclusion
Appendicectomy is a common and often urgent surgery that plays a vital role in treating appendicitis and preventing life-threatening complications. It is usually required when the appendix is inflamed, infected, or has ruptured. Advances in minimally invasive surgery have made the procedure safer and recovery quicker.
If you or someone you know experiences sudden lower abdominal pain, especially on the right side, don’t ignore it. Prompt diagnosis and treatment can make all the difference. Surgery, in this case, is not just a treatment—it’s often a lifesaving decision.
