Our Summary

This study examined whether it is necessary to invert the remaining part of the appendix (the appendiceal stump) during a laparoscopic appendectomy, a surgical procedure to remove the appendix. The research involved 327 patients who had this operation between 2012 and 2020. The patients were divided into two groups - those who had the stump inverted and those who did not. The researchers found that there was more severe inflammation and contamination in the abdomen in the group that did not have the stump inverted, and these patients also tended to be older, heavier, and in poorer overall health. However, after taking these differences into account, they found that there was no significant difference in complications or length of hospital stay between the two groups. The researchers concluded that it is not necessary to invert the appendiceal stump during an appendectomy to prevent complications.

FAQs

  1. What was the main purpose of the study on laparoscopic appendectomy?
  2. What was the health impact observed in patients who did not have the appendiceal stump inverted during the appendectomy?
  3. Did inverting the appendiceal stump during an appendectomy make a significant difference in the complications or length of hospital stay?

Doctor’s Tip

A helpful tip a doctor might tell a patient about appendectomy is to follow post-operative instructions carefully, including taking prescribed medications, avoiding strenuous activities, and keeping the incision clean and dry to prevent infection. It is also important to attend follow-up appointments with your healthcare provider to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for an appendectomy include those with acute appendicitis, which is inflammation of the appendix. Symptoms of acute appendicitis include abdominal pain, fever, nausea, and vomiting. In some cases, a perforated appendix may also require surgical removal. Additionally, patients with a history of recurrent appendicitis or those with a tumor in the appendix may also be recommended for an appendectomy.

Timeline

  • Before the appendectomy:
  1. Patient experiences abdominal pain, typically starting in the middle of the abdomen and then moving to the lower right side.
  2. Patient may experience nausea, vomiting, loss of appetite, and low-grade fever.
  3. Patient undergoes physical examination, blood tests, and possibly imaging tests like ultrasound or CT scan to diagnose appendicitis.
  4. Once appendicitis is diagnosed, patient is scheduled for laparoscopic appendectomy surgery.
  • After the appendectomy:
  1. Patient undergoes laparoscopic appendectomy surgery, which involves making small incisions in the abdomen and removing the appendix.
  2. Patient is monitored in the recovery room before being moved to a hospital room.
  3. Patient may experience pain, soreness, and fatigue after the surgery.
  4. Patient is given pain medication and instructed on how to care for the incision sites.
  5. Patient is encouraged to walk and resume normal activities gradually.
  6. Patient is discharged from the hospital within a day or two after surgery.
  7. Patient follows up with the surgeon for a post-operative appointment to ensure proper healing.
  8. Patient gradually resumes normal activities and diet as directed by the surgeon.

What to Ask Your Doctor

  1. What is the purpose of inverting the appendiceal stump during an appendectomy?
  2. What are the potential risks or complications associated with not inverting the appendiceal stump?
  3. Are there any specific factors or characteristics that would make inverting the appendiceal stump more important in certain patients?
  4. How common is the practice of inverting the appendiceal stump during an appendectomy?
  5. Are there any alternative methods or techniques that can be used to reduce the risk of complications if the appendiceal stump is not inverted?
  6. What is the typical recovery process like for patients who have had an appendectomy without inverting the appendiceal stump?
  7. Are there any long-term implications or considerations for patients who have had an appendectomy without inverting the appendiceal stump?
  8. Are there any additional precautions or follow-up care that should be taken if the appendiceal stump is not inverted during an appendectomy?
  9. How does the decision to invert or not invert the appendiceal stump during an appendectomy impact the overall success rate of the surgery?
  10. Are there any ongoing research or developments in this area that may change the current recommendations for inverting the appendiceal stump during an appendectomy?

Reference

Authors: Bekki T, Abe T, Namba Y, Okimoto S, Mukai S, Saito Y, Oishi K, Fujisaki S, Ohdan H, Fukuda T. Journal: Asian J Endosc Surg. 2023 Apr;16(2):203-209. doi: 10.1111/ases.13137. Epub 2022 Oct 27. PMID: 36300645