What is the medical term for appendix removal?

Appendectomy: The Medical Term for Appendix Removal

Appendectomy is the medical term for surgical removal of the appendix. This procedure is the standard treatment for acute appendicitis and is one of the most common emergency surgical procedures performed worldwide 1.

Types of Appendectomy Procedures

There are two main surgical approaches for appendectomy:

1. Laparoscopic Appendectomy:

   • Currently the preferred and most common approach 2
   • Involves 2-3 small incisions for insertion of trocars
   • Offers advantages of less pain, shorter hospital stay, and quicker return to activities 3
   • Has largely replaced open surgery in most settings 2

2. Open Appendectomy:

   • Traditional approach with a single larger incision in the right lower quadrant
   • May be necessary in complicated cases or when laparoscopy is contraindicated
   • The McBurney incision, developed in 1893, remains a fundamental technique 4

Technical Aspects of Appendectomy

During the procedure, regardless of approach, the surgeon:

• Identifies the appendix (location may vary)
• Ligates the base of the appendix and its arterial supply
• Removes the appendix, typically in a specimen retrieval bag during laparoscopy
• Ensures hemostasis and inspects the surgical field 2

Special Considerations

1. Normal-appearing Appendix:

   • The 2020 World Journal of Emergency Surgery guidelines suggest removing the appendix even if it appears normal during surgery when no other pathology is found in symptomatic patients 1
   • This recommendation is based on evidence that surgeon's macroscopic judgment of early appendicitis is often inaccurate, with studies showing 19-40% of apparently normal appendices having inflammatory changes on histology 1

2. Stump Appendicitis:

   • A rare complication occurring when the appendiceal stump (>5mm) is left behind
   • Can cause recurrent symptoms mimicking appendicitis
   • Prevention requires proper identification of the appendiceal base and complete removal 5

3. Outpatient Management:

   • Selected patients undergoing laparoscopic appendectomy for uncomplicated appendicitis can be safely discharged on the same day 3
   • Most patients with non-perforated appendicitis can be discharged within 23 hours after surgery 2

Perioperative Management

• Preoperative Antibiotics:

  • Broad-spectrum antibiotics are strongly recommended before appendectomy, especially in elderly patients 1
  • Reduces the risk of surgical site infections and intra-abdominal abscesses 1

• Postoperative Care:

  • Antibiotics may be continued postoperatively in complicated cases (perforated or gangrenous appendicitis)
  • For uncomplicated appendicitis, postoperative antibiotics are generally not necessary if adequate source control is achieved 1

Historical Context

The term "appendectomy" was first coined by Reginald Heber Fitz in 1886 4. The first successful appendectomy was performed much earlier, in 1735, by Claudius Amyand 4. Laparoscopic appendectomy was introduced in 1981 by Kurt Semm, revolutionizing the surgical approach to this common condition 4.

The procedure has evolved significantly over time, with modern techniques focusing on minimally invasive approaches, faster recovery, and reduced complications.