Removal of appendicitis by laparoscopic method

Laparoscopy refers to minimally invasive surgical methods. This manipulation is prescribed for many pathologies of the digestive tract, reproductive and genitourinary systems. The last decade, the method of laparoscopic research has been actively used to operate on patients with inflamed appendicitis, when it comes to elective surgery and the absence of a serious danger to life the patient. Before laparoscopy, it is imperative to undergo a small medical examination, according to the results of which the specialist will be able to determine how safe such treatment is for a particular patient.

When is laparoscopy used for appendicitis?

The method of such treatment can be used for patients suffering from acute and chronic types of pathology. At the first type of the disease, the patient complains of a strong increase in body temperature, the blood picture changes, and there may be a slight and quite tolerable pain on the right side. The main location of painful sensations in this case is the right side and groin area, but gradually the discomfort may shift. The pain, taking into account the complications of the condition, will increase and become difficult to tolerate.

Attention! If acute appendicitis develops in patients in whom the process is located close to the bladder due to anatomical features, elements of red blood cells may appear in the urine.

In the chronic form of appendicitis, the diagnosis can take a long time, since the disease usually manifests itself only with systematic pain in the ilio-groin region. Surgery is performed only with a confirmed diagnosis.

Attention! This method of treatment is especially recommended for patients with diabetes mellitus, since their condition often causes purulent processes during massive surgical interventions. The use of the laparoscopic method minimizes the possibility of inflammation during the recovery period.

Contraindications to the use of laparoscopy for appendicitis

Despite the fact that this technique is one of the safest and most gentle, it cannot be used with the following contraindications:

• problems with blood clotting;
• the last trimester of pregnancy;
• inability to use general anesthesia;
• there is an abdominal operation in the patient's past history;
• too large a patient's body weight with a significant fat layer at the incision site;
• there is no data on the real inflammatory process, but if a long period of time is impossible to determine the exact diagnosis, laparoscopy is still performed, but more as a method diagnostics;
• there are serious purulent processes outside the abdominal region;
• registration of dense infiltration in the affected area;
• the appearance of signs of a possibly developing peritonitis or its real development;
• the presence of adhesions in the intestine.

Attention! If you are overweight or have minor bleeding problems, your specialist may make a decision about laparoscopy, but only if there are no other complicating factors circumstances. Especially often, experts neglect the contraindication in the form of overweight, since strip surgery for such patients is even more dangerous than the laparoscopic method.

Benefits of this type of treatment

Abdominal surgery is a serious test for the patient's health. In this regard, the method of laparoscopy is several times safer and more productive. The patient does not need a long stay in a hospital, there is no increased pain syndrome during the recovery period. Also, the intestines are restored several times faster, which relieves the patient of problems in the form of constipation or diarrhea. This in turn reduces the risk of dehydration or intoxication during the recovery period.

Attention! This operation is also good from an aesthetic point of view. The incisions are short and scar quickly, leaving a small, barely visible line on the skin.

Rules for the removal of appendicitis during laparoscopy

Usually, such an intervention is planned in advance, since in case of emergency, almost 100% of patients are operated on with the abdominal method. For the intervention, the specialist will always require blood tests and ultrasound results. In the acute type of the disease, an X-ray examination is mandatory, during which a specialist may find additional difficulties in the form of accumulated solid feces and other violations. The anamnesis must be checked for the contraindications described above. The operation is always performed strictly under general anesthesia.

If the operation is planned and not of an acute nature, the patient is prepared as much as possible for it. An enema must be prescribed, which will eliminate the accumulated feces, relieve increased gas formation, which can interfere with the normal work of the surgeon. Also, two hours before the start of surgery, the patient is administered therapeutic doses of antibiotics and sedatives. If the patient's condition deteriorates rapidly, doses of antibiotics are administered and immediately sent to the operating table.

Attention! For a better passage of the laparoscopic tube, the patient is placed with a slight tilt of the body to the left side. Due to this position, the cecum moves towards the liver, which allows for safer manipulation.

The operation itself consists of several mandatory stages:

• the surgeon carefully examines the patient's abdominal cavity for external and other damage;
• then the sore spot is treated with an antiseptic drug and an incision is made;
• for the convenience of the specialist and the safety of the patient, two upper and two lower incisions are made on both sides of the abdomen;
• the specialist inserts a special tube with a camera into the incision, with the help of which he again carefully examines the abdominal cavity, but already inside the patient;
  

  Operation by the abdominal method and by the method of laparoscopy

• using special forceps, the surgeon exposes and slightly pulls the appendicitis to the side to the incisions;
• the next stage of the operation is the excision of the mesenteric part of the intestine;
• as soon as the mesentery is excised, special forceps grab the inflamed process and remove it;
• simultaneously with its removal, the specialist carries out the sanitation of the cut so that the inflammatory process does not advance through the digestive system;
  

  Operation of laparoscopy

• only after carrying out antiseptic treatment, appendicitis is removed through the incisions;
• as soon as it was removed, a complete sanitation of the peritoneum is also carried out, with developed peritonitis, drainage is placed;
• after extraction, the doctor examines the wound again so that there is no pus and working tools left in it;
• the last stage of treatment is suturing and external treatment of the incisions with an antiseptic.

Possible complications after laparoscopy to remove appendicitis

By-effect	Frequency of manifestation
Perforation of appendicitis due to clamp weakness	Rarely
Perforation of the blind intestine	Rarely
Poor closure of an artery duct leading to appendicitis, which causes bleeding	Sometimes
Poor debridement of incisions, stitches and sore spots	Sometimes
Small bruises on the abdominal wall	Often
Necrotic processes in the remainder of appendicitis	Sometimes
Hernia formation on incisions	Rarely
Development of peritonitis after surgery	Rarely
Massive bleeding due to damage to the arteries	Rarely

Attention! In many ways, the appearance of side effects after surgery depends on the qualifications of the surgeon and the presence of contraindications to the procedure, which were ignored.

The recovery period after laparoscopy with appendicitis

Regardless of what type of appendicitis required surgery, the patient after medical manipulations should stay in bed for 4-6 hours. If there is a normal wound healing process, the patient does not experience serious complications, the stitches are removed 9-10 days after the intervention.

Attention! If the stitches become wet, the patient is prescribed additional treatment with sterile tampons with Iodinol. With suppurations of a small nature, brilliant green is prescribed, with which the seams are processed 2-3 times a day.

It is not uncommon for specialists to suture with absorbable suture. Inside, such materials completely dissolve on their own and do not cause intoxication. Outside, such threads simply fall off when the wound has tightened enough and can begin to heal on its own.

Without fail, after carrying out laparoscopic manipulations, the patient is injected with an antibiotic, which protects the patient from a possible inflammatory process and suppuration. Physical activity is prohibited during the recovery period.

Attention! Without fail, the patient is put on a strict diet, which completely excludes the use of spicy, salty, fatty and fried foods. Proper nutrition on low-fat soups, light cereals allows the digestive system to adapt to new conditions and avoid diarrhea or constipation.

Laparoscopy is one of the most gentle methods of treating appendicitis, but only if there are no urgent indications for the treatment of a dangerous condition that has arisen. If the technique of performing the surgical intervention is observed, the recovery period takes a minimum of time and the patient can quickly return to a full-fledged and familiar way of life.

Video - Laparoscopy of appendicitis