Appendectomy

What is an appendectomy

An appendectomy is a surgical procedure, performed under general anesthesia, to remove the appendix.

The timing of this surgery can depend on many factors, such as:

  • Whether the appendix is non-perforated or perforated (burst)
  • The extent of the infection
  • The length of time your child has had symptoms

An appendectomy is the standard treatment for non-perforated appendicitis, and can also be used in the treatment of perforated appendicitis, alone or combined with other treatment options such as medical management that includes long-term antibiotics and possibly a drainage procedure before the appendix is surgically removed.

If your child has an appendectomy at The Children’s Hospital of Philadelphia, it can be done in two ways:

  • Laparoscopic appendectomy: With the minimally invasive laparoscopic method, three very small incisions are made in the abdomen, with the largest being at the belly button. A miniature camera called a laparoscope is placed through one of the incisions. Special instruments are placed through the other incisions to grasp and remove the infected appendix. The small incisions are closed with dissolvable sutures and a special glue called DERMABOND on the skin.
  • Open appendectomy: A small incision is made in the right lower portion of the abdomen. The appendix is found and removed. The small incision is closed with dissolvable sutures and a special glue called DERMABOND on the skin.

Visit our Guide to Your Child's Surgery to learn more about what to expect on the day of your child’s surgery.

Recovery and follow-up care

Your child’s recovery and follow-up care after his appendectomy will depend on if his appendix was perforated (ruptured) or non-perforated.

After surgery for non-perforated appendicitis

If your child's appendix has not ruptured, he will remain hospitalized for 1 to 2 days after surgery. Your child will be able to drink when he has recovered from anesthesia. After tolerating liquids, he will be able to eat and drink whatever he would like.

In order to be discharged from the hospital, your child needs to be able to walk, eat and drink without vomiting, be without fever and have good pain control with the pain medicines prescribed. Your child may be discharged from the hospital with a prescription for pain medication.

After being discharged from the hospital, your child will be able to return to school when he is comfortable and no longer taking the prescribed pain medication. This will be different for each child. Your child will not be able to participate in physical education or sports for 2 weeks after the procedure. Your child will also not be able to lift anything heavy; this includes a heavy book bag.

If your child’s appendix did not rupture, you will have the option of bringing him back for a postoperative visit or receiving a postoperative phone call from one of the surgical nurse practitioners 2 to 3 weeks after being discharged from the hospital. During the visit or phone call, the pathology of the appendix will be discussed with you.

After surgery for perforated appendicitis (burst appendix)

After surgery to remove a burst appendix, your child will remain hospitalized until he is without fever, tolerating food and drink by mouth, and comfortable using only oral pain medications. The length of hospitalization will be different for each child. Initially, your child will be on IV fluids until he is able to eat or drink. Your child will receive IV pain medications and antibiotics during this time.

Your child will be able to eat and drink as tolerated. When he is tolerating food and drink by mouth, both the pain medications and the antibiotics will be changed to the oral form. When your child is ready to be discharged, he may be sent home from the hospital with a prescription for pain medication and antibiotics.

Your child will be able to return to school when he is comfortable and not taking the prescribed pain medication. This will be different for each child. Your child will not be able to participate in physical education or sports for 2 weeks after the procedure. Your child will also not be able to lift anything heavy; this includes a heavy book bag. Your child will return for a follow-up appointment in the General Surgery Clinic 2 to 3 weeks after being discharged from the Hospital.

When to call the doctor

Please call us if your child following has any of the following:

  • Fever greater than 101.5 degrees F
  • Vomiting or unable to tolerate any food or liquids
  • Increasing or continuous abdominal pain
  • Abdominal distention
  • Drainage from incisions
  • Redness or swelling of the incisions
  • Any further questions or concerns

Appendicitis is considered an emergent condition. If you think that your child may have appendicitis, please have him evaluated at the Emergency Department.

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