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Appendectomy Treatment In Mumbai

Expert Emergency and Elective Laparoscopic Appendix Removal for Appendicitis at Shree Hospitals

Appendicitis - inflammation of the appendix - is the most common cause of emergency abdominal surgery worldwide. Appendectomy (surgical removal of the appendix) is the definitive treatment and a life-saving procedure when performed promptly. At Shree Hospitals, our general surgery team performs laparoscopic appendectomy as the preferred technique - using three small keyhole incisions, delivering excellent visualisation, faster recovery, fewer wound complications, and earlier discharge compared to open surgery. Our 24/7 emergency surgery service ensures that patients with appendicitis are operated promptly, minimising the risk of perforation and its serious complications.

What is Appendectomy?

The appendix is a small, finger-shaped pouch attached to the caecum (the beginning of the large intestine) in the lower right abdomen. Its function in adults is not clearly defined, though it is thought to play a minor role in gut immunity. Appendicitis occurs when the appendix becomes blocked (by a hardened piece of stool called a faecolith, mucus, or in rare cases a tumour), leading to bacterial overgrowth, inflammation, swelling, and eventually perforation (rupture) if not treated. The condition typically begins with central abdominal pain that migrates to the right iliac fossa (the lower right abdomen - the point of maximum tenderness is called McBurney's point), accompanied by nausea, vomiting, loss of appetite, and fever. It is the most common cause of emergency abdominal surgery in all age groups.

Appendectomy (removal of the appendix) is the standard treatment for appendicitis. Without surgery, an inflamed appendix typically progresses to perforation within 24 to 72 hours, causing peritonitis (infection of the abdominal cavity) and sepsis - a life-threatening complication. Laparoscopic appendectomy is now the gold standard approach in most centres, offering better visualisation of the abdomen (allowing identification of other pathology if the appendix is normal), smaller wounds, less post-operative pain, lower wound infection rate, and faster recovery compared to open appendectomy. The appendix, once removed, is not missed - its absence has no known long-term health consequences.

At Shree Hospitals, our emergency surgical team is available 24 hours a day to perform laparoscopic appendectomy for all patients presenting with appendicitis. We follow the ALVARADO score and clinical assessment to guide operative decision-making, supported by CT scan (the most accurate imaging for appendicitis) or ultrasound in selected cases. For perforated appendicitis with generalised peritonitis, we perform laparoscopic washout and appendectomy with peritoneal irrigation and drain placement. Interval appendectomy (planned elective removal after initial conservative treatment of early uncomplicated appendicitis with antibiotics) is also offered in selected patients.

Who Needs an Appendectomy?

• Acute appendicitis - the primary indication; confirmed clinically, with blood tests showing raised white cell count and CRP, and on CT scan or ultrasound
• Perforated appendicitis - appendix has ruptured causing peritonitis; requires urgent emergency surgery
• Appendix abscess - a walled-off collection around a perforated appendix; treated initially with percutaneous drainage followed by interval appendectomy at 6 to 8 weeks
• Recurrent appendicitis - repeated mild episodes of right iliac fossa pain attributed to the appendix; interval appendectomy prevents a future acute episode
• Incidental appendectomy - occasionally performed during another abdominal operation (such as laparotomy or gynaecological surgery) to prevent future appendicitis

Is Laparoscopic Appendectomy Right for You?

• A diagnosis of appendicitis has been confirmed or is strongly suspected clinically and on imaging
• You are medically fit for general anaesthesia
• You are not at term pregnancy (laparoscopy is modified but not contraindicated in pregnancy)
• The surgeon's assessment confirms laparoscopic approach is feasible
• Perforated appendicitis: laparoscopy allows thorough peritoneal washout, which may be more thorough than open surgery in experienced hands
• Obese patients: laparoscopy provides better visualisation of the right iliac fossa in obese patients than open surgery through a small incision

24×7 Emergency Care

Our Approach To Appendectomy

At Shree Hospitals, every patient with suspected appendicitis is assessed promptly, investigated appropriately, and operated without delay when the diagnosis is confirmed. We use a structured clinical pathway to ensure consistent, safe, and efficient care from emergency department presentation to discharge.

Rapid Diagnosis and Decision-Making

Prompt diagnosis is critical in appendicitis. On arrival at the emergency department, patients with suspected appendicitis are assessed by the emergency physician and the general surgery team simultaneously. Blood tests (FBC, CRP, electrolytes, liver function, amylase, urine dipstick, pregnancy test in women of reproductive age) are drawn immediately. CT scan of the abdomen and pelvis (with IV contrast) is the most accurate investigation (sensitivity and specificity over 95%) and is performed promptly. Ultrasound is used as the first-line investigation in children and pregnant women (to avoid radiation) with CT scan reserved for equivocal cases. The clinical and radiological findings are integrated using the ALVARADO scoring system to guide operative decision-making.

Laparoscopic Appendectomy Technique Laparoscopic appendectomy

Performed under general anaesthesia through three port sites (typically umbilical, suprapubic, and left iliac fossa). The abdominal cavity is fully inspected to confirm the diagnosis and exclude other pathology (ovarian cyst, Meckel's diverticulum, mesenteric adenitis). The appendix is identified, the mesoappendix is divided using an energy device (LigaSure or Harmonic), and the base of the appendix is secured with two endoloops or a stapling device and divided. The appendix is placed in an Endobag and removed through the umbilical port. The abdomen is irrigated and inspected for haemostasis. For perforated appendicitis, thorough peritoneal washout with warm saline is performed and a drain placed.

Management of Complicated Appendicitis

Perforated appendicitis with peritonitis requires urgent surgery and intensive post-operative care. Our team performs laparoscopic washout, appendectomy, and drain placement for perforated cases. Post-operatively, patients receive IV antibiotics (guided by intraoperative peritoneal fluid culture) for 3 to 5 days. For appendix abscess (pericaecal collection), the preferred initial management is CT-guided percutaneous drainage followed by interval appendectomy at 6 to 8 weeks. This staged approach reduces the complication rate of operating through an acutely inflamed phlegmon. Appendix tumours (found incidentally in 1 to 2% of appendix specimens - most commonly carcinoid tumours or mucoceles) are managed according to histological findings after consultation with the oncology team.

Top General Surgeons Specialists in Mumbai

Every specialist at Shree Hospitals is board-certified and has an average of 15+ years of clinical experience in laparoscopic appendectomy, emergency surgery, perforated appendicitis management, and complex abdominal surgery.

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