Our Summary

This research study looked at the risk of small bowel obstruction (SBO) after an appendectomy in children. The appendectomy could either be done laparoscopically (using a camera and small instruments inserted through small incisions) or through an open surgery. The study found that the risk of SBO was not significantly different between the two surgical approaches. However, the risk of SBO was significantly higher in cases where the appendix had burst (perforated) or when there was an abscess (a pocket of pus) in the abdomen after surgery.

FAQs

  1. Does the type of appendectomy (laparoscopic or open surgery) affect the risk of small bowel obstruction (SBO) in children?
  2. Is the risk of SBO higher if the appendix has burst or if there’s an abscess in the abdomen after surgery?
  3. What are the main findings of the research study on the risk of SBO after an appendectomy in children?

Doctor’s Tip

To reduce the risk of small bowel obstruction after a laparoscopic appendectomy, it is important to follow your doctor’s post-operative care instructions closely. This may include avoiding strenuous activities, eating a healthy diet high in fiber, staying hydrated, and taking any prescribed medications as directed. Be sure to contact your doctor if you experience any symptoms such as abdominal pain, bloating, vomiting, or changes in bowel movements after surgery.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy are those with uncomplicated appendicitis, meaning the appendix has not burst and there are no abscesses present. This minimally invasive approach is preferred in these cases as it typically results in less pain, shorter hospital stays, and quicker recovery times compared to open surgery. However, in cases where the appendix has burst or there is an abscess, open surgery may be necessary to ensure proper drainage and treatment of the infection.

Timeline

Before laparoscopic appendectomy:

  1. Patient presents with symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient undergoes physical examination, blood tests, and imaging studies (such as ultrasound or CT scan) to confirm the diagnosis of appendicitis.
  3. Surgeon recommends laparoscopic appendectomy as the treatment option.

During laparoscopic appendectomy:

  1. Patient is given general anesthesia and positioned on the operating table.
  2. Surgeon makes small incisions in the abdomen and inserts a camera and specialized instruments to remove the appendix.
  3. The appendix is removed and the incisions are closed with sutures or surgical tape.

After laparoscopic appendectomy:

  1. Patient may experience some pain, swelling, and discomfort at the incision sites.
  2. Patient is monitored for complications such as infection, bleeding, or bowel obstruction.
  3. Patient is discharged from the hospital within a day or two and instructed on post-operative care and follow-up appointments.
  4. Patient can usually resume normal activities within a week or two.

Overall, laparoscopic appendectomy is a minimally invasive surgical procedure that offers several advantages over traditional open surgery, including faster recovery time, less pain, and smaller scars.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a laparoscopic appendectomy?
  2. How long is the recovery time expected to be after a laparoscopic appendectomy?
  3. Will I have any dietary restrictions or special instructions to follow after the surgery?
  4. How soon can I return to normal activities, such as work or exercise, after a laparoscopic appendectomy?
  5. What measures can I take to help prevent small bowel obstruction or other complications after the surgery?
  6. Will I need any follow-up appointments or tests after the surgery to monitor my recovery?
  7. Are there any specific signs or symptoms I should watch for that may indicate a potential complication or infection after the surgery?
  8. How experienced is the surgical team in performing laparoscopic appendectomies?
  9. What is the success rate of laparoscopic appendectomies in treating appendicitis?
  10. Are there any alternative treatment options for appendicitis that I should consider before deciding on a laparoscopic appendectomy?

Reference

Authors: Håkanson CA, Fredriksson F, Lilja HE. Journal: J Pediatr Surg. 2020 Nov;55(11):2419-2424. doi: 10.1016/j.jpedsurg.2020.02.024. Epub 2020 Mar 2. PMID: 32192735