This database contains information on Board certified Gastroenterology surgeons in the United States specializing in appendectomies .
The appendix is a pouch at the junction of the small and large intestines. The size of the small finger, it is lined with a mucous membrane that produces a clear secretion. This organ has no known function. One theory, though, is that it plays a role in the immune system very early in life.
Location of
appendix
Detailed Location of appendix
Partly digested food and liquids traveling through the bowel pass in and out of the pouch when it is open. If this flow is blocked, bacteria trapped in the appendix may multiply and the appendix may become swollen and infected. If this happens, the condition is called appendicitis . If the infected appendix is not treated by antibiotics or surgery in a day or two, the appendix may break open and can cause pus to spread inside the thorax cavity (peritoneum) and cause infection there. An infection of the peritoneum is called peritonitis, and if not treated within hours, can cause death.
An appendectomy is surgery to remove the appendix.Most appendectomies are conducted using laparoscopic techniques, where minimal invasive surgery is used (i.e. small incisions and small resultant scars). Laparoscopic appendectomy is a reliable procedure which can be completed within 20 to 30 minutes under general surgery. The resultant hospital stay is two or three days rather than six or seven stay days.
How a Laparoscopic Appendectomy Works
A small
incision is
made in
the abdomen where the large intestine and the appendix are located
(lower right abdominal quadrant). The appendix is grabbed by a grasping instrument and pulled
upward.
Pic Courtesy www.transmed.net
A small hole is cut into the blood supply membrane material (mesoappendix) under and at the base of the appendix. This "window" (mesenteric window) allows a cauterizing instrument to slide through the hole and around the appendix at its base.
Pic Courtesy www.transmed.net
When the cauterizing instrument is inserted through the hole and squeezed tight, it is then "fired" to cauterize and separate the appendix from the large intestine.
Pic3
Pic Courtesy www.transmed.net
When the cauterizer is fired, it cauterizes (cuts and separates the appendix and cauterizes (burns) the two openings, sealing them). The result is a separated and sealed appendix and a sealed point at the large intestine. Sometimes this sealed point is stapled or sutured. The mesoappendix is cut and acuterized with the same cauterizer to completely separate the appendix.
Pic Courtesy www.transmed.net
The appendix is then removed and placed into a biologic disposal bag.
The peritoneal cavity is irrigated thoroughly with normal saline solution. This may require a number of separate "washes" if the appendix was ruptured prior to or during the operation. Also if the appendix ruptured, there is often a tube temporarily inserted into the peritoneum for a few days connected to a drain bag on the outside of the abdomen to to drain any excess peritoneal fluids that may accumulate.
The peritoneal wall is then sutured, any muscle tissue sutured, and finally the skin. The operation is complete.
A protocol of anti-biotics is usually initiated for seven days as an insurance policy to make sure no additional infection take hold.
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