Also known as: appendix removal, surgical removal of the appendix.

What is appendicitis?

The appendix is a tube-shaped organ attached to the colon in the right lower part of the abdomen. When the appendix becomes blocked with stool or inflammation, an illness called appendicitis, most doctors recommend removal by a procedure known as appendectomy. Simple appendicitis—present in two thirds of children with the disease--is when the organ is only inflamed, but not burst open. Complicated appendicitis is when there is rupture, and the inflammation has spread throughout the abdomen (peritonitis) or has formed an abscess.

What happens during the procedure?

Most modern surgeons perform laparoscopy where a telescope and up to two other instruments are introduced through small wounds into the abdomen to remove the organ through the belly button. At Nicklaus Children’s we specialize in scarless appendectomy, using only one wound hidden in the navel. In rare cases where bleeding or inflammation in the area is too severe, the surgeon will make an incision in the right side of the abdomen and remove the appendix that way.

Is any special preparation needed?

The surgery is performed under general anesthesia, and therefore, oral intake is withheld while waiting for operation. Antibiotics will be ordered for the child to help control the infection.

What is the recovery like?

If the appendix is not already ruptured, the child can go home on the same day resuming gentle activities of daily living immediately. He or she usually returns to school in two to four days and resumes full activities in two weeks. If there is perforation at the time of operation, the patient will need antibiotics for 1 to 2 weeks after operation. These are continued by IV in the hospital until eating is back to normal, usually 2 to 4 days, and then the rest of the course is completed at home.

What are the risk factors?

If the appendix is not ruptured, the complication rate is less than 5% (1 in 20) while perforation leads to a 20% (1 in 5) complication rate. Most complications are infectious, redness in the wound or an abscess in the abdomen, although rarely others like bowel blockage, bleeding or organ injury can occur.

Pediatric Surgery Team achieves excellent appendectomy outcomes

A recent study of pediatric surgery for appendicitis showed that Nicklaus Children's Hospital had some of the best outcomes of any children's or community hospital in the United States. Nicklaus Children's Hospital had an extremely accurate ruptured appendix diagnosis rate due to a greater use of ultrasound, CT scans and x-rays before performing surgery. The study by the Child Health Corporation of America (CHCA) also indicated that Nicklaus Children's Hospital had a lower rate of appendix rupture than three-fourths of all surveyed hospitals.

Analyzing hospital stays, the CHCA study reported that patients at Nicklaus Children's Hospital spent less time than average in the operating room and recovery room after appendicitis surgery, as 30 percent of the hospital's appendectomies were performed by laparoscopy. Nicklaus Children's Hospital patients also had shorter hospital stays for both ruptured and non-ruptured appendixes, a very low readmission rate of just 1.3 percent. 

Reviewed by: Cathy Anne Burnweit, MD

This page was last updated on: October 03, 2019 11:53 AM

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