The appendix is a small organ located on the right side of the colon where the small intestines continue into the large intestines. It is thought to be to be involved primarily in immune functions. The most common indication for removal of the appendix is inflammation. Rarely, the appendix may need to be removed because of a malignancy. The complications of appendix surgery can be divided into those directly related to surgery, and those related to anesthesia used during surgery.
Surgical Complications
An appendectomy may be performed via an open technique or a laparoscopic technique. The open technique involves making an incision in the right lower abdomen and operating under direct vision. The laparoscopic technique involves the use of three or more tiny incisions and using a camera and special instruments to remove the appendix. There are complications, which can occur irrespective of technique; however, there are few that may develop relevant to the technique used.
Open Technique Complications
During this procedure, there may be excessive bleeding, which is difficult to control. Another intraoperative complication is injury to surrounding organs such as the colon, but this rarely occurs. Perhaps the most common complication of an appendectomy is a wound infection. Wound infections occur in about five percent of appendectomies, according to Sabiston Textbook of Surgery.
Laparoscopic Technique Complications
Along with the complications that can occur during and after open appendectomy, there are a few complications that are specific to the laparoscopic technique. To perform a laparoscopic removal of the appendix, small incisions must be placed at various locations on the abdomen including just below the navel. Through these incisions, instruments called trocars are placed to house other surgical instruments, as well as the camera to be used during surgery. It is possible that while positioning these trocars, injury may occur to various organs within the abdomen including the small and large intestines, the stomach and the abdominal aorta. Such injuries are rare. Another complication unique to laparoscopic surgery is respiratory failure from the increased pressure placed on the chest by the use of carbon dioxide to inflate the abdomen during the procedure. Such complications usually happen in persons who already have decreased lung function prior to the procedure.
Anesthetic Complications
Anesthetic complications are not unique to appendectomy, but can occur in any procedure in which anesthesia is used. Anesthetic complications are rare. Allergic reactions may occur to drugs used to induce anesthesia. There may difficulty inserting the breathing tube and laryngospasm, which is a spasm of the windpipe, creating great difficulty in breathing. Nausea and vomiting are the most frequent complications of anesthetic use.
References
- "Sabiston Textbook of Surgery"; Townsend Jr., C et al.; 2008
- "Swartz: Principles of Surgery"; Swartz, S et al.; 1999
- "Washinton Manual of Surgery"; Doherty, M.G. et al.; 2002
