LAPAROSCOPIC APPENDECTOMY

Laparoscopic appendectomy is best option then open appendectomy....

Laparoscopic Appendectomy:

                        Appendicitis 

 

Let first we know what is appendix? 

The appendix is a tube like structure  that ended connected  to the cecum. which is a pouch like  located at the point  of the large and small intestines. It locate near the hip bone, below the live and lower right side of the abdomen.

ANATOMY & STRUCTURE  OF APPENDIX :

The appendix is a small, tube-shaped pouch attached to your large intestine. It’s located in the lower right side of your abdomen. 

FUNCTION OF APPENDIX :

Appendix is a vestigial organ in the body.The exact purpose of the appendix isn’t known. However, it’s believed that it may help us recover from diarrhea, inflammation, and infections of the small and large intestines. These may sound like important functions, but the body can still function properly without an appendix.

#APPENDICITIS :

 Appendicitis is the most common disease of the appendix. It’s a common emergency suitation due to infection in appendix,some time severe infection (pus in the appendix) due to which blockage & bacterial infection occur then they form inflammation in appendix. During the time of inflammation and infection, multiplication of   bacteria  fast inside the appendix then they bacterial infection  increases formation of pus,  they cause severe and more than severe pain in the right side of the abdomen (this is unbearable pain) & also pain recognized  below to the liver they all conditions causes appendicitis.

#Appendectomy 

What Is an Appendectomy?

An appendectomy is the surgical removal of the appendix.The fast and easy procedure to treat appendicitis is to remove the appendix by laparoscopic surgery. If unfortunately patient will not treated at right time and any moment very inflammed and very infectious appendix ruptured or burst, blast inside the abdominal cavity then bacteria and fecal particles within the appendix  spread into  abdomen. This condition to form  serious infection to peritoneum (protective covering for abdominal cavity)cavity is called peritonitis, that causes absess and pus inside the whole body this suitation is converting for emergency operating conditions major surgery laprotomy. Both are serious or life-threatening conditions that require immediate surgery. Thats why patient  have to take right dicision at the correct time.consult the doctor if you have  find appendicitis.

What Are the Risks of an Appendectomy:

Most of the biggest  risks it is if you have know  you are suffering from appendicitis  but you have no take treatment and any decision at right time then that mistake cause rupture of appendix and lots of pus (abscess) & peritonitis developed. this suitation caused by untreated appendicitis & delay in treatment.

#Diagnosis of Appendicitis –

1.Physical examination –severe pain right side of the abdomen  

2.Imaging (film pictures) techniques –

1.Ultrasound and Computed Tomography (CT scan)=help in verifying if the appendix is inflamed, swollen or ruptured.

2.Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) = Help to detect rare tumours of the appendix. (Tumors are rarely found).

3.chest x-ray for lungs conditions 

3.Blood Tests – 

#The white blood cell count(WBC)  signs of infection (WBC=11, 0000-14000) can help diagnose if there is an inflammation of the appendix.

Causes of Appendicitis –

1.blockage in the opening at the attachment of appendix with caecum.

2. Collection of mucus or stool in the appendix after they  hardens and block the opening. swelling of the lymphatic tissue in the appendix that causes the blockage.

3.If the inflammation goes undetected, it may lead to rupturing of the appendix

Symptoms of appendicitis are:

-Continue  but slow pain in the centre (belly botton) of the abdomen. The pain cannot be identitying in the beginning.

-Inflammation of the peritoneum.

-Severe abdominal pain

-stomach pain right side of the abdomen

-Abdominal swelling

-Cramp in abdominal muscles

-Constipation or diarrhea

-Nausea &vomiting, coughing. 

-Loss of appetite.

-Low-grade fever.

How Do patient  Prepare before  for an Appendectomy surgery? 

You will need someone to drive you home for surgery.  You will also need someone to stay with you overnight. Ask your doctor or nurse how much help you might need.

1.NILL BY MOUTH(NBM): Avoid eating and drinking for at least 8 to 10 hours before the appendectomy.

2.Allergy  test done by before surgery by nursing staff.

3.Take  history of  any previous surgery and any long term disease like blood pressure and diabetes and any cardiac or kidney problem. 

4.The morning of your surgery, you may take medications your doctor told you are allowed. Take them with just a sip of water.

5.You might need to stop taking certain medicines before surgery. These include blood thinners, supplements, and medicines that affect your immune system. Talk to your surgeon when you schedule your laparoscopic gallbladder removal.

Position : supine position (patient lie in straight position ).

Anesthesia :laparoscopic appendectomy surgery done under the general anesthesia.

Painting & drapping: abdomen is painted betadiene solution and drapped by sterile towel.

How Is a laparoscopic  Appendectomy Performed?

During a laparoscopic appendectomy, a surgeon accesses the appendix through three small incisions in abdomen. A small, narrow tube called a veris needle or hasan technique (blunt trocar) will introduce in the abdomen. The veris needle technique  or hasan technique is used to inflate your abdomen with carbon dioxide gas. This gas make space under the abdomen for introduce the instruments & performing surgery  and allow to  full view on  the screen and other organs.

                 Once the abdomen is inflated, an instrument called a laparoscope (10mm telescope ) will be introduce through the incision. The laparoscope is a long, thin tube(light source cable) with a high-intensity light and a high-resolution camera attched at the end of laparoscope . This camera will display the images on a big screen.When the appendix is found, it will be tied off with three endoloop & if endoloop is not available then 1no. Sutupak silk will be used for stiches and appendix will be removed. The small incisions are then cleaned, closed, and dressed with small dressings pad like G-dress or tegaderm and also with glu and staplers.

What are done by doctor and nursing staff after the surgery =

Post operative care:

1.The patient is observed for minimum 3 to 4 hrs in recovery room.Its depend on patient physical conditions if patient not well so it should be kept for 8 to 10 hours.

2.Periodic checkup of pulse, blood pressures amount of drain output if drain is put.

3.If heamoglobin is less and blood  is required then started blood transfusion.

4.continued fluid.

5.antibiotics for first 48 hours.

6.ambulate (walk)patient two hourly as per surgeon advised.

7.If any drain put inside the abdomen they remove to before hospital discharge.

8.change the dressings before the hospital discharge.

What are the risk & complications after the surgery:

1.bleeding from the site of surgery 

2.Infection 

3.fever and chills due to infection 

4. Pain in the abdomen and incision sides.

Follow-up to review doctor:

During this time, your doctor will probably recommend that you limit physical activity so your body can heal. You’ll need to attend a follow-up appointment with your doctor within two to three weeks after the appendectomy.