There are two major types of appendectomy procedures: traditional open surgery and laparoscopy.

Traditional open surgery involves making an incision in the patient’s lower right abdomen and removing the appendix using surgical instruments. This technique is used in many appendectomies, particularly when a patient’s appendix has ruptured. Open surgery allows the surgeon greater access to the abdominal cavity, which may require cleaning with fluid if infectious material has entered the cavity following a ruptured appendix. Other factors that make open surgery more likely than laparoscopic surgery include:

• Extensive infection or abscess
• Obesity
• History of prior abdominal surgery that has resulted in dense scar tissue
• Inability to see the organs using a laparoscope
• Bleeding problems that develop during laparoscopic surgery

Laparoscopic surgery requires just a few small incisions into the abdomen. A thin tube called a laparoscope is inserted into one of the incisions through a hollow instrument called a cannula. The laparoscope has an attached camera and light that provide a magnified view of the interior of the abdomen. The surgeon views the image on a monitor and inserts instruments into the other incisions to remove the appendix with minimum scarring.