appendectomy
Meaning of appendectomy: Removal of the appendix, among the commonest emergency abdominal operations, now usually done through three small cuts rather than one.
Definition of appendectomy
An appendectomy is surgery to remove the appendix, the narrow blind-ended tube attached to the cecum, the pouch where the small intestine empties into the large intestine. It is performed most often for appendicitis, in which the tube becomes blocked, inflamed and infected. The operation is done either through several small cuts using a camera or through one larger incision.
Why is it done?
Almost always for appendicitis. The appendix has one narrow opening into the bowel, and if that opening is blocked by hardened stool, swollen lymphoid tissue or rarely a tumor, the trapped secretions have nowhere to go. Pressure rises inside the tube, its blood supply is squeezed, bacteria multiply and the wall becomes inflamed and can eventually die and burst. A burst appendix spills infected contents into the abdomen, which is far more dangerous than the original inflammation and much harder to treat. Removing the appendix before that point is what the operation is for. It is occasionally taken out for other reasons, including a tumor found in it, or removed as an aside during unrelated surgery.
How do the two approaches compare?
| Approach | Access | Typical course |
|---|---|---|
| Keyhole | Three small cuts and a camera | Less wound pain, faster return to normal |
| Open | One cut in the lower right abdomen | Preferred where the abdomen is badly contaminated |
Most are now done as laparoscopic surgery, and an operation begun that way is sometimes converted to the open approach when the view is poor or the appendix has already burst.
Is the appendix useless?
The old description of it as a leftover of no value has not held up. Its wall is rich in lymphoid tissue, and the narrow dead-end shape appears to shelter a reserve population of gut bacteria that can repopulate the large intestine after a severe bout of diarrhea. None of that makes it essential, and life after removal is unchanged. It does explain why antibiotics alone are now an accepted option in selected uncomplicated cases, resolving the attack without surgery, at the cost of a proportion of people returning with another episode later.
Also known as
Used in a sentence
An appendectomy was performed laparoscopically without complication.
Good to know
The appendix carries lymphoid tissue and appears to act as a reservoir for gut bacteria rather than being a useless remnant, and antibiotic treatment alone resolves many uncomplicated cases, though a proportion of those recur.
Word origin
Where “appendectomy” comes from
Appendix comes from the Latin appendere, meaning to hang from, and the ending -ectomy comes from the Greek ektome, meaning a cutting out.