Pre-operative Preparation following a Laparoscopic Appendicectomy procedure
There is some important information about the pre-operative preparation for this procedure. It is imperative that you read this.
Read about Bowel Pre-operative Preparation
Procedure
About laparoscopic appendicectomy
This operation is to surgically remove the appendix. This is usually done for acute appendicitis but may be done for chronic inflammation (grumbling appendix) or rarely, pathology associated with the appendix such as a tumour or mucocoele. The appendix is part of the bowel and is attached to the caecum.
Indications
See above.
Anaesthesia and antibiotics
The operation will be performed under a general anaesthetic, administered by an anaesthetist. Antibiotics will be given in the operating room.
Operative procedure
The appendix is being removed using keyhole surgery. There is a 10mm incision just below the umbilicus (belly button) and two 5mm incisions, one on the left side and one just above the pubic bone within the bikini line. The artery feeding the appendix is divided. The appendix base is then ligated and the appendix transected and removed. If done for acute appendicitis great care is taken to wash out the whole of the abdominal cavity with saline, particularly if there has been perforation and the presence of pus.
Laparoscopic appendicectomy (appendectomy)
Post-operative Care following a Laparoscopic Appendicectomy procedure
Pain
Because your operation has been done laparoscopically the level of discomfort you experience should be less than with an open operation. However it is inevitable that you will experience some discomfort. In particular this will be in the region of where the appendix used to be on the right hand side. You will also experience some discomfort associated with the three small incisions - one just below the umbilicus or navel and the two smaller incisions. Long acting local anaesthetic will have been injected into the wounds but after a few hours this effect will wear off. Before it does so it is important to have some pain killers on board and to continue these on a regular basis. You will be sent home with some pain killers - my preference is either Panadeine Forte or Nurofen. I recommend that you take these initially on a regular basis as directed on the packet. After about 48hrs it should be necessary to take these only as required.
Wound Care
The three wounds will each have a dressing. Leave these in place until they fall off. If they haven't fallen off within a week they can be safely removed at this point. It is perfectly safe to allow the dressing to get wet whilst in the shower - simply dab dry with a towel - this also applies to the exposed wound once the dressing have been removed. There will be some dissolving stitches beneath the wounds that do not require removal.
Wound Infection
This is an unusual occurrence but if it does happen it's usually on day 4 or 5. If the wounds become red, painful and swollen please contact Dr Renaut's office or if he is not available your local GP. A short course of antibiotics may be necessary.
Physical activity (including sexual activity)
It is very important to maintain a degree of physical activity following your operation. Please feel free to move around the house and go for short walks starting in the immediate post-operative period. The degree of physical activity that is permissible is largely common sense. Too much will simply increase your discomfort level. As a general rule you should slow down if the wounds or the operation site becomes uncomfortable and build up gradually each day. Certainly within a week to 10 days you should e able to pursue normal day to day activities, with the exception of lifting heavy objects - this should be avoided for a period of 4 weeks following the surgery. Resuming sexual activity is once again a matter of common sense - it should be introduced on a gradual basis. Driving can be resumed after 1 week.
Medication
You should resume your normal regime of medication as soon as you are able to eat and drink after the surgery, unless specifically directed otherwise by Dr Renaut or your anaesthetist. As previously mentioned you will be discharged with some pain killers which should initially be taken regularly and then as required. Antibiotics are not normally prescribed by Dr Renaut as the chances of infection associated with this procedure are minimal.
Follow up
Dr Renaut does not routinely see his patients for a follow-up appointment. In most cases it is not necessary. If however you have concerns about your recovery then he is very happy to discuss these on the phone and he will arrange to see you if he thinks this is necessary. He routinely notifies your GP of all procedures and your progress.