Procedure definition

An appendectomy is the surgical removal of the appendix, a small, finger-shaped pouch attached to the beginning of the large intestine in the lower right abdomen. The appendix has no vital function, but when it becomes inflamed or infected—a condition called appendicitis—it can rupture and cause serious infection inside the belly.

Most appendectomies today are performed laparoscopically, meaning the surgeon makes three small incisions, inserts a camera and instruments, and removes the appendix without a large cut. The camera gives a clear view of the abdomen, allowing a safe and quick operation that typically takes 30–60 minutes.

In some cases, especially when the appendix has already ruptured, when infection has spread widely, or when scar tissue or anatomy makes it difficult to see, the surgeon may perform an open appendectomy through a single incision of about 2–4 inches in the lower right abdomen. Open surgery is also used for certain pregnant patients or when laparoscopic tools aren’t available.

Both approaches are effective, but laparoscopic surgery generally leads to less pain, smaller scars, and faster recovery.

Why it’s done

The main reason for surgery is acute appendicitis, an infection caused by blockage of the appendix opening—usually by hardened stool, swollen lymph tissue, or occasionally a foreign body. Symptoms often include sudden abdominal pain that starts near the belly button and moves to the right side, along with nausea, fever, or loss of appetite.

If untreated, the appendix can burst (perforate), spilling infection into the abdominal cavity and leading to peritonitis, which can be life-threatening. For this reason, appendicitis is considered a surgical emergency.

In select mild cases detected early, some hospitals offer antibiotics-only treatment, which can resolve symptoms temporarily. However, studies show that 25–40% of these patients eventually need surgery later, so appendectomy remains the definitive treatment.

Chronic or “smoldering” appendicitis (recurrent mild pain episodes) and incidental discovery of appendiceal tumors are less common reasons for removal.

Risks & complications (with numeric ranges)

Appendectomy is one of the most common and safest emergency operations, but all surgeries carry some risks.

Overall complication rates:
• Uncomplicated appendicitis: 5–10%
• Perforated or gangrenous appendicitis: 15–25%
Major complications: occur in 3–5% of all patients.

Specific risks include:
• Wound infection: 1–3% after laparoscopic, up to 10% after open or perforated cases.
• Intra-abdominal abscess: 1–3%, higher when appendix ruptures before surgery.
• Bleeding or hematoma: <1–2%.
• Ileus (temporary bowel slowdown): 2–5%.
• Bowel injury: <1%.
• Conversion to open surgery: 2–5%.
• Venous thromboembolism (blood clot): <1%.
• Mortality: <0.1% in healthy adults; higher (1–2%) in frail or elderly with ruptured appendix.

Most complications are treatable with antibiotics, drainage, or additional minor procedures. Because appendicitis often affects younger patients, outcomes are generally excellent when surgery is performed promptly.

Recovery

Hospital stay:
• Uncomplicated laparoscopic appendectomy: many patients go home the same day or after one night.
• Open or perforated cases: 2–4 days on average, depending on infection severity.

Activity:
Light walking is encouraged the day of surgery to prevent clots and promote healing. Most people return to desk work or school within 1–2 weeks, and to strenuous jobs or sports in 3–4 weeks. After open surgery, recovery may take a bit longer.

Diet:
You can drink fluids soon after surgery and usually eat normally within 24 hours. A high-fiber diet helps bowel movements return to normal. Temporary constipation or bloating is common for a few days.

Wound care:
Keep the incisions clean and dry; most are closed with dissolving stitches or surgical glue. Watch for redness, drainage, or fever—these can signal infection.

Pain control:
Mild soreness lasts about a week and is usually managed with non-narcotic pain relievers.

Follow-up:
One post-op check is typical about 1–2 weeks after surgery. Full recovery for most people is achieved within a month, though fatigue can linger briefly.

Surgeon types

Appendectomy is performed by General Surgeons, often on call for emergency cases. They are trained in both laparoscopic and open techniques. In children, the operation is performed by Pediatric Surgeons using smaller instruments. In very complex cases—such as abscesses extending into other organs—interventional radiologists may first drain infection before the surgeon removes the appendix later (“interval appendectomy”).

Outcomes are better in hospitals where surgeons perform appendectomies frequently; higher volume correlates with lower complication rates and shorter hospital stays.

Representative citations

1. American College of Surgeons (ACS): “Appendectomy—Patient Education.”
2. NIH MedlinePlus: “Appendectomy” overview and post-operative care.
3. World Journal of Surgery (2017): Large multicenter review; overall morbidity 7%, mortality 0.1%.
4. CODA Trial (NEJM 2020): Compared antibiotics vs. surgery; ~29% required surgery within 90 days, showing appendectomy remains definitive.
5. SAGES Guidelines (2021): Laparoscopic appendectomy preferred for faster recovery and fewer wound infections.