Indications:
The appendix is an out-pouching of the bowel about the size of your little finger. It lies low down in the right side of your abdomen. Quite commonly the appendix gets swollen and causes pain. If left it can end up bursting inside the abdomen causing serious infection and illness, and in exceptional cases be fatal. A diseased appendix needs to be taken out. Sometimes in patients with suspicious symptoms, the appendix may turn out to be normal when examined. In cases of doubt, it is safer to remove the appendix than to risk developing complications of leaving a diseased appendix inside.
Procedure:
The appendix is dissected out, cut off at its base and then removed. Any associated pus collection is thoroughly washed out. The operation is done through three small cuts (key hole surgery), one at the belly button for the laparoscope, and then the two others for the operating instruments. The appendix is removed through one of the wounds and the wounds are then stitched up. If the operation cannot be completed laparoscopically, the procedure will be done by making a longer cut/incision in the lower tummy over the right side.
- The main surgical complication is a wound infection and can occur in up to 15 % of patients.
- This risk is higher if the appendix has burst. The wound infection may settle with antibiotics and wound care, but the wound may need to be re-opened, either in the ward or in theatre.
- Other risks include bowel injury, bleeding, delayed return of bowel movement, blood clots in your legs, lung collapse or lung infections like pneumonia.
- Late complications may occur such as a suture granuloma (a mass that forms at the site of the surgery) or a hernia at the site of the wounds.
After your consultation:
- Obtain authorization from your medical aid and book your bed for your hospital admission.
- Carefully read through pre-operative information provided.
Day before surgery:
- Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).
Day of surgery:
- Arrive for admission at indicated time on ‘Code & Consent’ sheet.
- Change into theatre attire, remove all valuable belongings.
Approximately 45-90 minutes.
Duration of hospital stay:
- 1-3 days (dependent on pain management, general state of patient and first bowel movement).
Activities:
- Refrain from strenuous activities (incl. exercise) for at least 4 weeks post-operatively.
Back to work:
- Sick leave required post-operatively is approximately 7-14 days.
Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:
- Warming devises in theatre as well as warm intravenous fluids.
- Intra-operative pain medication through the drip.
- Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
- As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.
More procedures performed by Dr Jeske
A SKIN INCISION IS MADE AND THE CONTENTS OF THE ABSCESS IS DRAINED.
THE FISTULA TRACT IS IDENTIFIED AND IS OPENED ALONG ITS LENGTH, AND THE EXPOSED INSIDE OF THE TRACT IS THEN CLEANED OUT.
THE COMMON BILE DUCT (CBD – THE MAIN TUBE CARRYING BILE FROM THE LIVER TO THE INTESTINE) IS OPENED UP. ANY GALLSTONES WITHIN THE DUCT CAUSING A BLOCKAGE CAN BE REMOVED.
PTC is a procedure performed by a radiologist (specialist X-ray doctor) who takes X-ray pictures of the bile ducts which are tubes inside the liver.
THE PANCREAS IS EXPOSED AND FREED FROM THE ADJACENT ORGANS. THE TAIL (DISTAL) HALF OF THE PANCREAS IS REMOVED. THE BLOOD VESSELS THAT GO TO THE SPLEEN PASS THROUGH THE PANCREAS. AS A RESULT THE SPLEEN ALSO SOMETIMES NEEDS TO BE REMOVED.