Surgery for appendicitis as the main method of treatment

What is appendicitis? Appendicitis - inflammation of the appendix( appendix of the cecum).

Causes of appendicitis: food allergy, fecal concrements, impaired innervation, helminthic invasion. Four forms of the disease flow into each other: catarrhal, phlegmonous, gangrenous and perforating. Already in the second stage all layers are affected. Further, tissue necrosis occurs and a perforated form develops.

The disease always has an acute onset: severe pain is localized in the epigastric zone, passes into the right iliac part. The pain does not stop, it increases during the turn from the left to the right side. Plus to this - malaise, weakness, fever up to 37,2-37,6 С.

Someone may have nausea, vomiting, constipation. In the process of palpation of the abdomen, soreness appears on the right side, the tension of the anterior abdominal wall. Still can be added specific symptoms:

• Razdolsky( pain in the left ileal region with jerks);
• Obraztsova( pain when lifting the right leg).

Blood rises in ESR, leukocytosis is detected.

Surgery for appendicitis

Treatment of the disease can only be prompt. Moreover, the operation to remove appendicitis is carried out in an emergency. The traditional method is considered effective. But today more and more popular becomes laparoscopic apedectomy( the appendix is ​​removed through small punctures in the abdominal cavity).

It is important to remember that before surgery it is not possible to administer painkillers to a patient, to use local heat to the area of ​​inflammation, to do enemas or to give laxatives.

So, for the recognition of appendicitis, a histological examination is carried out. If the diagnosis is confirmed, urgent surgery is needed. With an unclear diagnosis, the patient is observed 3-5 hours and is carefully examined. Only after this is shown the operation.

Preoperative preparation of

Most patients with acute appendicitis require minimal preparation. Before surgery, you must exclude the ingestion of water and food through the mouth, and also shave the front abdominal wall and pubis.

If appendicitis is destructive, then complex intensive therapy will be required. Each case is individual.

Carrying out the operation

All the action is under anesthesia or local anesthesia. Anesthesia is preferable for complicated forms of the disease. Usually, when the vermiform appendage is removed, the Volkovitch-McBurney cut is used.

Sometimes, especially if the diagnosis is unclear, pararectal access is used. When opening the abdominal cavity, you need to find a vermiform appendage. Its base is in the zone of the dome of the cecum, at the junction of three muscle bands. Free access facilitates all actions. A positive effect is also good anesthesia and examination of the ileocecal region.

Scythe with dome removed to the wound, mobilized by ligation, dissected with mesentery. Then a catgut ligature is applied to its base. Above her, the process is cut off. The cult is immersed in z-shaped and pouchy sutures. The toilet of the abdominal cavity is carried out, the wound is sutured or drained. In a destructive disease with exudate, the abdominal cavity is drained by a micro-irrigator to introduce antibiotics.

The temperature after the operation of appendicitis can last for a week. Gauze drainage is performed in the following cases:

1. When peripendicular tissues or fragments of the inflamed process have not been removed during appendectomy.
2. If the capillary bleeding from the bed does not stop.
3. When due to inflammatory processes in the caecum there is no confidence in the seal hermetic.
4. As drainage of a purulent cavity, when a peri-pendicular abscess is opened.
5. If an appendicular infiltrate is found during the operation and the inflamed process is not removed due to the risk of damaging the intimate organs welded to it.
6. For the prevention of retroperitoneal phlegmon with destructive retroperitoneal appendicitis.

After operation

For 12-24 hours, you should adhere to bed rest, apply cold on the wound, take painkillers for up to two days. If complications did not arise, the intestinal peristalsis will recover on the second-third day.

Eating after the operation of appendicitis is as follows: you can drink and take liquid food after 8-12 hours, if there is no dyspeptic disorder.

Usually, a special diet after the operation of appendicitis is not prescribed. It is only necessary to gradually return to the usual mode of eating. After the operation to remove appendicitis, antibiotics are taken only with complications.

Operation without incisions

Today there is an alternative to painful manipulations - laparoscopy of appendicitis. New equipment allows you to remove the diseased organ through the mouth or vagina.

Super thin instruments are brought through the mouth to the operating site, through the microscopic opening penetrate into the abdominal cavity. At the same time, you do not have to apply seams. At the moment, dozens of such operations have been successfully carried out.

The postoperative period is minimal. Recovery after an operation of appendicitis passes quickly. Extract is carried out in a few hours. The risk of complications is reduced. Because bacteria get into the abdominal cavity with this method is more difficult.

Of course, the operation will not be completely painless. There is a possibility of internal bleeding. But if you compare with the traditional method of treatment of appendicitis, then this method is much more effective.