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Appendectomy

Know your options—a guide to minimally invasive procedures (MIP) for appendectomy

What is an appendectomy?

An appendectomy is the standard treatment to have your appendix removed.

When is an appendectomy needed?

Your appendix is a tube-like structure attached to the first part of your large intestine. Appendicitis occurs if the appendix becomes inflamed or infected. If left untreated, an inflamed appendix can rupture or leak and cause a serious infection. Appendicitis usually requires surgery one to three days after symptoms begin.

Know your options: MIP for appendectomy

MIP is used to perform more than 200,000 appendectomies every year.

MIP uses state-of-the-art technology to remove the appendix. When performing an MIP, the surgeon creates small, dime-sized incisions that allow the use of a miniature camera, or videoscope, and specialized instruments to perform the procedure -- avoiding a larger, incision or opening.

Today, more and more people are having their appendix removed with MIP, also known as laparoscopic surgery, which utilizes three or four dime-sized incisions instead of one larger incision.

Recovery time with MIP is shorter than with open surgery; patients experience less pain and scarring, and can generally leave the hospital and get back to the things that are important to them sooner.

How does MIP for appendectomy work?

Side-by-side comparison

Open appendectomy

MIP for appendectomy

During an open appendectomy, an incision is made in the lower right side of the abdomen, through the skin, muscle and an enclosing, protective layer of tissue in the abdomen called the peritoneum. This incision is usually two to three inches long and is held open so the surgeon can view the abdomen during the surgery. The appendix is isolated and separated from the large intestine. After the appendix is removed, the incision is then closed with sutures and/or surgical staples.

Using a videoscope (a miniature camera) that is inserted into one of the incisions, the surgeon views the appendix and surrounding area through a magnified image on a video monitor in the operating room. The surgeon then removes the appendix using long-handled instruments that are inserted in the other small incisions. Each of the dime-sized incisions is then closed with a few stitches. No surgical staples are required. Having your appendix removed (an appendectomy) is generally considered to be a low-risk surgical procedure associated with few complications and a short hospital stay.

Know the risks

All surgical procedures have risks, but the risk for serious complications depends on your medical condition and age, as well as on your surgeon's and anesthesiologist's experience. Ask your doctor or surgeon about what to expect after surgery as well as the risks that may occur with any surgery, including:

• Reactions to medications or anesthesia
• Problems breathing
• Bleeding
• Infection 
• Blood clots in the veins or lungs
• Death (rare)

Additionally, an open surgery has a greater potential for:

• Muscle injury
• Post-operative incisional hernia

Is an MIP for appendectomy right for you:

Choosing MIP vs. Open Surgery

For some patients, MIP is not an appropriate choice.  Your surgeon will help you determine the best choice for you and will consider factors such as:

• Obesity
• History of prior abdominal surgery causing dense scar tissue
• Inability to safely visualize organs
• Bleeding problems during the operation  
• Underlying medical conditions

The decision to perform MIP or an open surgery should be made during a discussion with your surgeon. Sometimes a procedure can start out as MIP, but may have to be converted to an open surgery based on the factors listed above.

Talk to your doctor

It's important to talk to your doctor about your care. Use these questions as a guide to help you.

• What is an appendix?
• Why is it sometimes necessary to remove an appendix?
• Can I prevent appendicitis?
• What are the symptoms of an inflamed appendix, or appendicitis?
• What are the potential benefits of MIP over an open surgery for appendicitis?

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