Before an appendectomy, patients typically receive a sedative that makes them sleepy. An intravenous (I.V.) needle is inserted in the back of their hand or forearm and is attached to an I.V. line. General anesthesia is administered through this line. Patients who receive general anesthesia will be unconscious and not experience any pain during the procedure.

During open surgery, a small incision is made through the skin and fat of the right lower part of the abdomen. The muscles are then separated, allowing the surgeon to access the peritoneum. The surgeon cuts the peritoneum to reveal the section of the large intestine that is attached to the appendix (known as the cecum). The surgeon moves the small intestine aside, separates the appendix from surrounding structures and ties off the blood vessels surrounding the site.

Once this has been accomplished, the appendix is removed from the body. Sutures or tiny staples are used to close the peritoneum, muscle wall and skin.

During the laparoscopic technique, three or four small incisions of about one-quarter inch to one-half inch (0.64 centimeters to 1.27 centimeters) in length are made in the patient’s abdomen. The laparoscope is inserted through a long tube called a cannula into one of the incisions. The light and camera attached to the laparoscope are used to project an image of the abdominal cavity onto a monitor. The surgeon uses this image to locate and remove the appendix with instruments that are inserted through cannulas into the other incision points. In some cases, these incision points may need to be lengthened to complete the procedure. Once the appendix has been removed, these incision points are sutured shut.