Appendectomy - the surgical removal of the appendix (appendectomy). Special term "appendix" means "an appendage, like a worm." The word "appendicitis" in which the people often referred to this operation, in fact, means inflammation of the appendix. Today, there are two types of operation: Classic and laparoscopic.
The classic version - appendectomy It is performed through a small incision in the right lower abdomen (iliac).
With laparoscopic equipment - appendix is removed using special tools and equipment through the individual pinholes of the abdominal wall.
Specific terms
- Laparotomy (Gr. Lapara stomach; -Tom cut) - is opening (slit) of the abdominal cavity.
- A laparoscope (Gr. Lapara stomach; scopy look) - the device endoscope is designed for manipulation of the abdominal organs. Most have an outer diameter of 5-10 mm. A laparoscope is a lens system and is connected to the camcorder. By laparoscopy is also connected optic cable, illuminated by "cold" light source (halogen or xenon lamp). Used complete with spetsialonymi laparoscopic instruments and endoscopic equipment.
- Laparoscopy (Gr. I look scopy) - examination of the abdominal cavity through an opening in the abdominal wall with the help of an optical instrument laparoscope.
- Laparocentesis (Gr. Kentesis puncture) - a puncture of the abdominal wall using the "trocar" is made to extract the contents of the pathological from the abdominal cavity, for example, in the ascites fluid.
Drainage - installation of special plastic tubes (drains) for the outflow of ottelyaemogo wound, blood, body fluids, etc.
How is the operation
The operation is performed under local or general anesthesia. The duration of the operation - from 30 minutes in the uncomplicated situation, up to 2 hours in complicated disease.
The classic version:
1. In the right iliac fossa incision of the skin and subcutaneous fat, then successively pushing the muscle and reach the peritoneum, the lining inside the abdominal cavity. It also opened.
2. Find an appendix ( appendix ) And removed it previously tied up at the base. His mesentery (ligament looks like a leaf that attaches the appendix to the structures of the abdominal cavity) and ligated carefully separate thread and crossed.
3. If at the time of surgery in the abdominal cavity in a small amount of peritoneal exudate available (liquid, occurs when inflammation of the abdominal cavity), it is removed gauze.
4. Carefully examine the other parts of the colon and small intestine for pathology.
5. The layer by layer (stages) sewed up the wound, the skin sutured.
If you detect peritonitis (inflammation of the peritoneum), then left to drain (tube) through which flows away from the abdominal cavity pus or serous fluid.
Laparoscopic method:
Inflamed appendix removed using special laparoscopic instumentov that are introduced into the abdominal cavity through a small 3-4 (0, 5 cm to 1 cm) incision in the abdominal wall. One of them made through the navel. After surgery marks on the skin are left.
Through one hole laparoscope is introduced with a video camera to observe on the monitor the progress of the operation, through the other - instruments (laparoscopic clamps, scissors) The special equipment throughout the operation increased the patient's organs on a monitor. In some cases, one of the sections can be increased to extract the appendix.
After the introduction of instruments audited (examination) of the abdominal cavity, determine the presence and extent of peritonitis, the form of the appendix, its location and Droege technical features of the operation.
During the operation, appendix gripping jaws of the mesentery, mesenteric and audited, according to the experience and capabilities of the surgeon, the nature of change in the mesentery and the availability of tools chosen way to its intersection. Then appendix removed from the abdominal cavity. In some cases, this increase is one of the incisions.
After surgery, the wound diameter of 5 mm adhesive tape glued 10 mm - sutured with absorbable filaments.
If necessary, leave a drainage tube.
Complications after appendectomy
Are rare, these include:
1. Damage to the colon.
2. bowel obstruction.
3. Accession of infection and abscess formation.
4. Damage to the ureter (extremely rare).
The duration of hospitalization
Total hospital stay in patients with uncomplicated appendicitis and no postoperative complications - 3-7 days.
When laparoscopic operation patients can be discharged after 2-3 days, performance is restored in 10-14 days.
Contraindications to surgery
In acute appendicitis contraindication to appendectomy does not exist, except for the agonistic state of the patient.
The average price of appendectomy in Moscow
Appendectomy classical method is free of charge.
Laparoscopic removal of the appendix - 15000-18000.
Treatment and prevention
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