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Appendectomies. Katie Duvall and Megan Cousins. The Day of Surgery… almost. T he Appendix. The appendix is a tube connected to the cecum near the base of the large intestine. It’s located in the lower right quadrant of the abdomen.
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Appendectomies Katie Duvall and Megan Cousins
The Appendix • The appendix is a tube connected to the cecum near the base of the large intestine. • It’s located in the lower right quadrant of the abdomen. • A healthy appendix is on average 10 cm in length, but can be from 2-20 cm. It has a diameter of about 7-8 mm.
The Appendix • The appendix is a vestigial structure. This means that it has been concluded that the appendix has no vital function in the human body. • This conclusion was made due to the fact that so many people have been able to survive without one. • The appendix has been traced back to evolutionary ancestors who probably used it to digest leaves.
Appendicitis • Appendicitis is the inflammation of the appendix. • There is a stage of bloating which is generally caused by a blockage in the opening from the appendix to the cecum. • This is formed by a thick layer of mucus or stool blocking the opening • When the mucus or stool hardens, it becomes rock-like and forms a blockage. • This “rock” is called fecalith. • The bacteria which is usually found in the appendix comes under attack from the immune system, causing inflammation. • Some cases are small enough to clear themselves, meaning that the body clears the infection without intervention, but most require surgery.
Signs and Symptoms of Appendicitis • The symptoms are fever, elevated white blood cell count and abdominal pain. • In the initial stages, the pain is “poorly localized,” meaning that it is experienced all over the abdomen and is hard to pinpoint. • As the inflammation worsens, it extends to the lining of the abdomen, called the peritoneum. • At this point, the pain is much more localized and can be pinpointed by the patient. • The point (known as McBurney’s point) is about halfway between the front of the right side of the pelvis and the belly button.
Complications in Diagnosis • Aside from the fact that appendix placement varies from patient to patient, there are many diseases that mimic symptoms of appendicitis. • Such diseases include: • Meckel'sdiverticulitis • Pelvic Inflammatory Disease • Right-sided diverticulitis • Various kidney diseases. • These can also cause pain and inflammation of organs in the lower right portion of the abdomen.
The Procedure of Appendectomy • When the patient is still pre-op, they are put on antibiotics. • A regular, uncomplicated appendectomy takes 20-30 minutes from start to finish. • The patient is put under anesthesia for the duration of the surgery. • The surgeon begins by making 3 small laparoscopic incisions in the lower right quadrant of your abdomen with trocars. • They puff up the abdomen by pumping CO2 into one of the incisions and confirm with a laparoscope that the appendix is red and inflamed.
Procedure continued • Surgical instruments are passed through the trocars. • The appendix is sealed off at two points to prevent bursting. • The surgeon will then cut the appendix between the sealed points. • A specimen bag is inserted through one of the trocars and the appendix is placed inside and then removed. • Warm salt water is then inserted through a trocar to remove leftover infectious material and then sucked out. • Two of the three trocars are removed, the final being left for CO2 drainage. • The surgeon uses sutures or staples to close the incisions and then a bandage is placed on them.
Sources • Anatomy: A Regional Atlas Of The Human Body, by Carmine D. Clemente • http://www.medicinenet.com/appendectomy/article.htm • YouTube: • http://www.youtube.com/watch?v=MAppEy9Umcg • http://www.youtube.com/watch?v=y2Xm1WqjqAc
