Know What Laparoscopic Appendectomy Is

Laparoscopic appendectomy (appendectomy) is a surgical procedure to remove an appendix or appendix that has an infection using the laparoscopic method. Laparoscopic appendectomy is an alternative method of open appendicitis surgery. Appendix or appendix is an organ in the body that looks like a sac, and its location is attached to the large intestine in the lower right abdomen. The appendix is about 4-10 cm in size and its function is unknown until now. The appendix can become inflamed due to bacterial infection that occurs when the opening of the appendix is blocked by feces. This condition is also called appendicitis (appendicitis). If appendicitis is not treated immediately, the appendix can rupture and cause bacteria and fecal particles to enter the abdominal cavity. This can cause a serious condition called peritonitis and can be life threatening. The most important type of appendicitis treatment is through surgical removal of the appendix or appendectomy. Appendectomy can be performed by open surgical techniques or by laparoscopy. Laparoscopic appendectomy is performed using a laparoscope, a long and thin tube-shaped device, and is equipped with a camera and light at the edges. Laparoscopic appendectomy has several advantages over open surgery methods, including:

• Pain is lighter than open surgery.
• Patients do not take too long to stay in hospital.
• The healing process is faster.
• Smaller scars.

Indications for appendectomy with laparoscopy

Appendectomy, both openly and laparoscopically, is performed on patients with appendicitis. However, the laparoscopic method is more recommended as the first choice in managing appendicitis than open surgical procedures, because of the various benefits that can be obtained by patients. However, laparoscopic appendicitis surgery is still carried out with several considerations, including:

• The physical condition of the patient makes it possible to undergo laparoscopy.
• The hospital provides laparoscope equipment.
• Doctors have the skills to use the laparoscope.

In addition, laparoscopic appendicitis surgery is also highly recommended for treating appendicitis patients with the following conditions:

• Being obese.
• Suffer from other diseases, such as diabetes or hypertension.
• Elderly.
• Children.

Warning:

• Tell your doctor if you have a history of allergies to the ingredients contained in anesthetic medicine.
• Tell your doctor if you have a blood clotting disorder, or have a history of heart and lung disease.
• Tell your doctor what type of drugs or supplements you are taking, especially blood thinners. Doctors can advise patients to stop taking drugs before undergoing surgical procedures.
• Tell your doctor if you have had surgery in the abdomen before or have bowel obstruction.
• Tell your doctor if you are pregnant.

Before Laparoscopic Appendectomy

Before the patient undergoes laparoscopic appendectomy, the doctor will explain various things related to the surgical procedure and the risks that may occur. After the patient understands the procedure to be performed, the doctor or nurse will provide a statement to be signed by the patient. The doctor will also carry out an examination of the patient's medical history, which includes complaints from the symptoms experienced by the patient, a history of the disease he has suffered, and a history of allergies. The doctor will also do a physical examination and laboratory tests (blood tests and urine tests). If needed, the doctor will perform several supporting examinations, such as X-rays, ultrasound, CT scans, and MRI. In addition, there are a number of things that patients need to prepare and do before undergoing laparoscopic appendectomy, including:

• Fasting for approximately 8 hours.
• Invite family members or close associates to accompany the patient while in the hospital and take the patient home. This is done because the patient may still be under the influence of anesthetic drugs, so it is not possible to drive a vehicle.

After the patient arrives at the hospital, the nurse will instruct the patient to remove all jewelry and other objects that are being worn, as well as take off clothes and replace them with surgical gowns. Next, the doctor or nurse will put an IV tube in the patient's arm to deliver the medicine and fluid during the surgical procedure. The patient will feel pain and discomfort when the IV needle is inserted. After preparation is complete and the doctor has ensured the patient's condition is stable, the patient will be taken to the operating room.

Laparoscopic Appendectomy Procedure

Laparoscopic appendectomy procedure generally lasts approximately 1 hour. The following are the steps for laparoscopic appendectomy:

• The patient will be laid on the operating table in the supine position.
• The anesthesiologist will inject an anesthetic (anesthetic) through an IV tube. The type of anesthesia used in this procedure is general anesthesia or general anesthesia, so that the patient will fall asleep during the procedure.
• The surgeon will make 1-3 small incisions in the abdomen around the navel as access to insert surgical instruments that will be used during the procedure.
• A small tube will be inserted to channel carbon dioxide gas into the patient's abdominal cavity, so that the stomach expands and the doctor can see the condition of the appendix and other organs clearly through the monitor screen.
• The laparoscope is then inserted through the hole and directed to the appendix.
• With the help of other surgical instruments, the doctor will tie the appendix with stitches, then cut and remove it.
• After the procedure is completed, carbon dioxide will be removed from the patient's abdominal cavity, and the doctor will remove the laparoscope and all surgical instruments.
• The doctor will cover the incision with stitches or surgical staples.
• The incision area will be covered with surgical bandages or tape

Appendix that has been removed will be brought and analyzed in the laboratory. If the doctor finds an abnormality that causes removal of the appendix can not be done by laparoscopy, then the doctor will perform an open surgical procedure. There are several conditions that cause appendectomy to be done with open surgery, including:

• Swelling in the abdomen, making it difficult for doctors to see the condition of the organ with a laparoscope.
• Appendix ruptured or perforated.
• Peritonitis or abscess.
• Bleeding occurs during the laparoscopic procedure.
• Appendix position is not normal.

After Appendectomy Laparoscopy

After the action is done, the patient will be taken to the observation room. The doctor will check the patient's vital signs, such as blood pressure, heart rate, and breathing frequency. The patient may experience pain in the shoulder and mild constipation for several days due to carbon dioxide gas used during the procedure. The length of recovery time depends on several things, namely:

• Overall physical condition of the patient.
• This type of anesthesia is used during surgery.
• The body's reaction to surgery.

After the doctor ensures that the patient's vital signs are stable and the patient has regained consciousness, the doctor will assess whether he can allow the patient to go home or have to be hospitalized. The doctor will give medicines that will be consumed by patients during the recovery period, such as antibiotics to prevent infections and pain relievers, both at home or while in the hospital. In addition, the doctor will also provide several instructions that can be done by patients during the recovery period at home, including:

• Rest enough to speed up the healing process.
• Ensure that the cut is clean and dry.
• Do not lift heavy loads for at least 2 weeks.
• Avoid strenuous activities, such as aerobic exercise, biking, or jogging.
• Avoid soaking for at least 2 weeks after surgery.
• Eat nutritious foods and increase fluid intake.
• Doing walking exercises regularly. Walking helps smooth blood flow and prevents constipation.
• Take medication according to doctor's orders.
• Carry out regular check-ups to prevent complications after surgery

Patients can undergo normal activities for at least 2-3 weeks after undergoing appendicitis with laparoscopy.

Risk of Appendectomy Laparoscopy

Laparoscopic appendectomy is a relatively safe surgical procedure performed. However, there are some risks that patients may experience, although this is rare. Among others are:

• Bleeding.
• Surgical wound infection.
• Injury to organs around the operating area, such as the small intestine, urinary tract, or bladder.
• Blood clots in the limbs.
• Leakage at the edge of the large intestine, where the appendix undergoes removal.

Contact your doctor immediately or visit the nearest hospital if you experience the following conditions:

• Fever with a body temperature of more than 39 degrees Celsius.
• Nausea or vomiting continuously.
• Hard to breathe.
• The pain does not go away even after taking pain medication.
• Diarrhea or constipation that lasts for more than 3 days.
• Redness and swelling in the incision area.
• Pus appears in the incision area.
• Bleeding.