Appendectomy

You will be admitted to hospital for the removal of your appendix. This procedure can be necessary following an inflammation of the appendix, which may have caused symptoms for some time, or it may be urgently required in the case of an appendix perforation.

Perhaps you have been hospitalised before and the inflammation needed to 'cool down' first by resting the body, possibly using antibiotics and a gradual recovery over six weeks. Once the inflammation markers in the blood have gone down, the surgery can proceed, as the risk of complications is lower. If the symptoms are acute and/or the appendix is perforated, you will be admitted to hospital and operated on as soon as possible.

The surgery can be performed through a small incision on the right side of the lower abdomen, known as keyhole surgery. The method depends on age, size of the abdomen and previous abdominal surgeries, among other factors.

If you are taking blood-thinning medication, you must tell the surgeon beforehand. You will need to stop using this medication well in advance of the surgery.

Usually, you will be admitted the day of your surgery (via A&E or the Admission Department). In case of a planned admission, you report to the hospital's Admission Department on the agreed date and time.

After registration, a nurse will guide you to your room and ask you a few more questions.

To ensure a smooth admission process, you can prepare a few things in advance, such as:

• Bring a summary of your home medication or bring the medication yourself.
• If you have anti-thrombosis stockings, these can be worn.
• Know how tall you are and how much you weigh.
• Bring any blood tests or a cardiogram if they have been done.
• Follow the fasting instructions: no solid food six hours before the procedure, but still water is allowed up to three hours before the procedure.
• You will need to be shaved/depilated from the lower part of the sternum to above the pubic area. You can do this in advance at home or it will be done on the ward.
  

Just before the operation, the nurse will ask you to put on the surgical gown. Any jewellery or false teeth will be removed. You may continue to wear your underpants.

The procedure is done under a general anaesthetic. During the operation, you lie on your back on the operating table.

After the operation, you will be taken to the recovery room. Your heart rate, blood pressure and the wound will be monitored. Once these functions are stable, you will be returned to the intermediate and long-term care wards. The checks for these functions will be repeated several times on the intermediate and long-term care wards.

You will have an IV in your arm for administering fluids and medications. Due to the general anaesthesia you received, you may only start drinking again an hour after being taken back to your room. After the operation, you will get out of bed to urinate. It is important to alert the nurse if you feel nauseous or are in pain. Medication may be administered for these.

In the evening, you will receive easily digestible, laxative food. You will receive a preventative injection of heparin. Normally, you stay in hospital (with overnight stay) for just one day. Before being discharged, the physician will visit you again and give you your discharge papers. You are not allowed to drive a car or any other vehicle for up to 24 hours after the anaesthesia.

• thrombophlebitis (clot formation in the lower limbs)
• wound infection
• wound bleeding
• formation of an abscess in the abdomen
• peritonitis

• For the first seven to 10 days, it is recommended to wear compression stockings (TED) (especially at night) because you still have reduced mobility.
• The home care nurse will visit you at home to administer a heparin syringe once a day for 10 days.
• A check-up with your GP is recommended between seven and ten days after your hospital discharge to review your wound.
• It is recommended to resume your activities as soon as you leave the hospital, provided it is not accompanied by pain. Cycling is best postponed for a week, though. There is a lifting restriction for three weeks.
• Post-operative pain is most pronounced in the first two to three days, and necessitates painkillers for most patients. Shoulder pain occurs in 25% of people and is caused by the CO2 gas used during the operation. This may persist for two to three days. Paracetamol three times a day, combined
• with ibuprofen three times a day, is usually sufficient. Afterwards, the pain medication is tapered off. Icing the abdomen can also relieve pain.
• Two to three weeks after the surgery, you will have a follow-up appointment at the surgery consultation. After this follow-up appointment, any previously imposed restrictions will be lifted. Healthy eating is recommended.

Latest publication date: 13/08/2024
Supervising author: Dr Monsaert Els