Appendicitis

Appendix surgery in Hyderabad

What is Appendicitis?

Appendicitis is a medical condition wherein the appendix gets blocked, infected, and inflamed. The appendix is a small, finger or tube-shaped pouch, about 2 to 4 inches long, projecting from the colon- a part of the large intestine. It is situated in the lower, right side of the abdomen. Once considered a vestigial organ, the appendix is now known as an important reservoir of beneficial gut bacteria. In young children, the appendix functions as a part of the immune system to help fight diseases.

Appendicitis can develop in any person, mostly it is seen in people aged between 10-30 years. In some people, inflammation of the appendix can cause the appendix to swell and eventually rupture, thereby spreading the bacteria all over the abdominal cavity from the inside of the bowel. The bacterial spread can cause infection of the bloodstream which can further lead to a fatal condition called sepsis. This bursting of the appendix is a medical emergency and must be treated immediately by removal of the appendix. Appendix surgery in Hyderabad is performed at Sree Nandaka Advanced Surgery Hospital, by Dr. Praveen Kumar Koduru, a senior laparoscopic and laser surgeon in Kompally, Hyderabad.

Symptoms of Appendicitis

Appendicitis typically first causes pain episodes in the middle of the abdomen, around the belly button. Within hours, the pain radiates to the bottom, right-hand side of the abdomen, becomes intense and lingers on. If any pressure is placed on this area like while coughing, walking, or any jarring movements, the pain gets worse. The pain may be felt in different sites of the abdomen in different patients, depending upon their age and the position of the appendix. Pregnant women having appendicitis will feel pain in the upper abdomen because the appendix is situated higher in the abdomen.

Besides pain, appendicitis can cause other symptoms like:

• Nausea
• Vomiting
• Appetite loss
• Sick feeling or low-grade feeling that may get severe with worsening of the condition
• Diarrhoea or constipation
• Gas
• Abdominal bloating.

Appendicitis Correction With Laparoscopy

Appendicitis is first treated with antibiotics that help treat bacterial infection. The standard treatment for this condition is appendicitis removal- the appendectomy surgery. Traditionally, appendectomy was performed by an open surgery using one abdominal incision of about 2-4 inches long. This is known as laparotomy in Hyderabad. However, in today’s time, appendix removal is done through a few key-hole incisions in the abdomen using specialised tools equipped with a camera and light at one end. This surgical procedure is called a laparoscopic appendectomy.  

Preparation for The Surgery

Most patients who require appendix removal in Hyderabad enter the emergency department and undergo surgery within a few hours of admission. Firstly, antibiotics are provided to the patient and then surgery is performed.

Before the surgery, an anaesthesiologist meets the patient to ask about his health status and the time he had his food last. Using the information provided by the patient, the anaesthesiologist provides the patient with the required amount of general anaesthesia so that the patient lies unconscious throughout the surgery and feels no discomfort. The patient must not eat or drink anything for at least 6-8 hours before the surgery.

The surgeon may provide the patient with special instructions before the surgery based on his/her medical condition. Therefore, the patients must inform the surgeon beforehand about their pregnancy or expectation of conceiving a child; any allergies; and if they have a medical history of bleeding disorders or taking any blood thinning drugs, supplements, or substances.  

The Laparoscopic Procedure for Appendectomy

Once the anaesthesia takes effect, the Appendicitis Treatment in Hyderabad will commence as follows:

1. The surgeon makes 2 or 3 tiny cuts near the navel and above the pubic region near the hip bone.
2. Through the incisions, the surgeon will insert a laparoscope (a thin tube fitted with a camera and light) to visualise the appendix. Another tube will be inserted to flow harmless carbon dioxide gas into the abdominal space. The gas makes enough space inside the abdomen to allow the surgeon to easily work.
3. Next, surgical instruments are inserted into the other incision(s) to clip and cut out the appendix from the large intestine.
4. In case of a burst appendix, the surgeon thoroughly cleans out the patient's abdomen so that there is no infection spread. Once done, the gas from the abdomen is released.
5. After the removal of the appendix and release of the air, the surgeon closes the incisions using surgical staples or a few, absorbable stitches or sutures. The appendix is sent to a laboratory to be tested for cancer. 
6. The skin incisions are closed using liquid skin glue or Steri-strips (thin adhesive strips) for shallow cuts. These fall off as the incision site heals. If steri-strips are used, the surgeon will cover the incision with gauze that is left for 48 hours. A sterile bandage or surgical dressing is used to cover the incision wounds.