Frequently Asked Questions

Gallbladder stones can present in different ways, the common symptoms are of “Indigestion”, right upper abdominal pain which may radiate to the right scapular area, Nausea and occasionally vomiting. Sometimes due to the Gallstones causing complications, the symptoms may be more acute and could be associated with severe pain in the upper abdomen and back, fever and jaundice. The symptoms typically occur after a fatty or heavy meal and tend to be recurrent.

Laparoscopic Cholecystectomy is an operation to remove the Gallbladder using a Laparoscopic (Keyhole) surgery. This procedure is most commonly performed for symptomatic Gallstones under General anaesthesia. It involves making 3-4 small holes on the abdomen, the largest of which is 10mm and the others being 5mm. The Laparoscope and instruments are inserted into the abdomen through these ports and the Gallbladder is securely detached from its connections and removed along with the Gallstones. The postoperative recovery is usually quite rapid, with most patients being able to walk within 6 hrs of the surgery and able to eat a semisolid meal in 8-10 hours. After being fully out of the effects of the anaesthetic agents. Occasionally the same procedure can be done by the SILS (Single-incision Laparoscopic surgery) method. This involves performing the entire operation through the Umbilicus (belly button). The post-operative recovery is the same as with a Multi-port laparoscopy. The biggest advantage of the SILS method is that after complete healing the scar is almost invisible, being hidden in the belly button.

You may find small, frequent meals easier in the first few days after your surgery. Increase your intake of foods at your own pace. While you do not need to keep to a specific diet after appendix removal, most patients feel more comfortable with smaller frequent and light meals. It is best to avoid fizzy drinks, alcohol, and large greasy meals until after the clearance is given by the team.

Dressings on your wound are removed at the time of discharge in most cases. You can wash your body, but please make sure you keep your wounds completely dry for the first 48 hours after your surgery. Pat the wounds gently when drying. Avoid using creams or ointments on your wounds until they have fully unless these have been specifically prescribed by the Surgeon.

Most patients can get back to their routines in about a week after the surgery(Laparoscopic). This may change depending on a variety of factors like the severity of the Appendicitis, pain threshold of the patient, intensity of the patient’s routine and pre-existing conditions to name a few.

Most patients can go home a day after the surgery. In cases where the Appendicitis has been complicated by a rupture or abscess formation, or sometimes due to other conditions, the discharge may be delayed by a few days.

It is normal to have some pain in your tummy and around the wound for a few days after your surgery. This can be managed with regular painkillers. Your tummy may feel bloated afterward, but this will settle in time. If you have had a keyhole(Laparoscopic) procedure, you may experience some pain in your shoulder. This is due to the air insufflated along with the instruments, which gets absorbed into the body. Walking around can help this to improve. You may also notice that you have a sore throat afterward. This is a transient sensation and is due to the breathing tube placed in your throat for the general anaesthetic.

Appendicectomy i.e removal of the Appendix is the Gold Standard for treatment of acute appendicitis. However, in certain situations surgery may be deferred to a later date or indefinitely: Appendicular lump formation: This is a situation where due to a delay in the presentation the Appendicitis has been “walled off” by the Omentum and small intestine forming a mass around the Appendix. This is nature’s way of preventing the infection from spreading in the abdomen. It is best to treat this with antibiotics and defer Surgery to a few weeks later when the mass has resolved. Some cases of mild Appendicitis where the inflammation is resolving rapidly and spontaneously with or without antibiotics. In this situation the Surgery may be deferred to the next episode of inflammation. It is a recognised fact that the subsequent Surgery can be more difficult due to adhesions and the possibility of an early rupture of the Appendix. Moribund patient: The very rare situation where the patient is moribund and considered unfit for an anaesthetic or surgery due to pre-existing medical conditions.

Appendicectomy is a surgical procedure to remove the Appendix. Most of the time the procedure is done Laparoscopically i.e by Keyhole Surgery. In this method,3-4 small cuts are made on the abdominal wall to introduce a camera and instruments. The cuts vary between 5 and 10mm. However, in some complicated situations, the surgery would be performed by the open technique, which entails cutting a few centimeters on the abdomen to remove the inflamed Appendix. In either of the methods, if the Surgeon deems it necessary, a tube drain may be placed to vent out the infected fluid. This is usually removed after a few days. Both the methods entail giving the patient a General anaesthetic.

As with any surgery there are certain risks associated with the procedure. Clearly one must understand that the surgery is performed only when it is deemed that the benefit of Surgery is far greater than the risks involved. Specific to an appendicectomy, the risks are related to the degree of infection in the Appendix. Patients with complicated or ruptured Appendicitis can have the following specific issues: 1. Recurrent infection leading to abscess formation. 2. Leakage from the Appendicular base. 3. Postoperative ileus-gaseous distension of the small intestine. 4. Postoperative sepsis syndrome- a rare life-threatening situation where the infection causes life-threatening dysfunction of multiple organ systems, usually seen in very late cases with diseases like Diabetes or compromised immunity.