Appendectomy is the removal of the appendix and the definitive treatment for acute appendicitis. It is performed chiefly laparoscopically, as an emergency, with rapid recovery when treated promptly.
What is an appendectomy?
It is the surgical removal of the appendix — a small tubular projection arising from the large bowel (caecum) — when it becomes inflamed (appendicitis). It remains the established, definitive treatment and is performed chiefly laparoscopically.
The goal is timely removal before perforation, which leads to peritonitis or an abscess. Appendicitis progresses quickly, so surgery is often urgent.
When is it needed?
It is indicated for acute appendicitis, confirmed by the clinical picture and imaging (ultrasound or CT). The presence of an appendicolith is a strong indication for surgery, as it carries a higher risk of perforation and of failure of non-operative treatment.
In selected, uncomplicated cases without an appendicolith, antibiotic treatment may be discussed, with the known risk of recurrence. For an inflammatory mass/abscess, drainage and antibiotics may come first, with possible interval surgery later.
Preparation
As an often-urgent presentation, it is preceded by rapid assessment: blood tests, imaging to confirm and exclude other causes, IV fluids and antibiotic prophylaxis. Any anticoagulants are managed.
How it's done
Under general anaesthesia, through three small incisions, the appendix is identified, the mesoappendix vascular pedicle is divided and the base is secured (with loops or a stapler). The specimen is removed in a retrieval bag to avoid wound contamination.
In perforation or peritonitis, the abdomen is thoroughly washed out; for a localised abscess a drain may be placed. Conversion to open is rare and is a safety choice in difficult anatomy.
Laparoscopic
The preferred technique: small incisions, less pain, faster return and better inspection of the abdomen.
Open
For advanced peritonitis or difficult cases, when it serves safety.
Complicated disease
For abscess/perforation: drainage, antibiotics and an individualised timing of surgery.
Recovery
In uncomplicated appendicitis, discharge is often within 1 day, with rapid return to eating. Return to daily activities follows within a few days.
In complicated disease (perforation/abscess), hospital stay and antibiotics are longer. Seek prompt review for fever, worsening pain or inability to eat.
Risks & outcomes
A safe, common operation. Risks relate mainly to the severity of inflammation: wound infection and an intra-abdominal abscess are more frequent after perforation. Less commonly: base/stump leak, ileus.
Early treatment dramatically improves outcome. "Success" means full recovery without complications and a rapid return.
Frequently asked questions
Is it always an emergency?
Acute appendicitis is generally treated urgently, to avoid perforation. In selected uncomplicated cases initial non-operative treatment may be discussed, but surgery remains the definitive solution.
Laparoscopic or open?
Laparoscopic is the preferred approach in most cases. Open is chosen for advanced disease or safety reasons.
How quickly will I recover?
In the simple form, most go home in 1–2 days and return to activities within 1–2 weeks.
Are antibiotics needed?
Yes, given around the operation; in complicated forms they are extended according to the picture.