Frequently Asked Questions

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.

Acute Appendicitis can present with a variety of symptoms, which can sometimes be confusing. The most common symptoms are pain and uneasiness around the belly button(Umbilicus) which later moves to the right lower quadrant of the abdomen. This may be associated with nausea and vomiting. Occasionally the patient may have loose stools or pain lower down in the abdomen on the right side or towards the back, due to the variability in positions of the Appendix. A diagnosis of Acute Appendicitis is made by a combination of a clinical suspicion that is confirmed by some blood tests and an ultrasound scan or a CT Scan of the Abdomen- Pelvis. Once confirmed, the gold standard of treatment for Appendicitis is Appendicectomy.

Acute Appendicitis is one of the commonest surgical emergencies occurring due to acute inflammation or infection of the Appendix. The Appendix is a small tubular structure found attached to the Caecum, which is the first part of the Large Intestine(Colon), situated in the right lower quadrant of the abdomen.

The only disadvantage of a Robotic Surgery is the cost. Surgery is more expensive than alternative methods of operating, but this is to be expected when such advanced technology and skill is being used. The advantages of Robotic Surgery far outweigh the cost disadvantage for the appropriate surgery.

Based on the diagnosis of your clinical condition and the planned Surgery, the Consultant Surgeon would give the patient the option of Robotic Surgery if it is deemed to confer an advantage to the patient and would improve outcomes. At this point all the pros and cons of the proposed Surgery and the probable alternatives like Open Surgery are discussed before a fully informed decision is made.

Most Laparoscopic (Keyhole) Surgeries can be performed using the Robot. The Robot is most useful in Surgeries needing manipulations in narrow, deep areas with many critical structures in the vicinity, for e.g: Rectal and Colon Cancer Surgeries. Stomach and Oesophageal Cancer Surgeries. Surgeries on the Oesophagus(Food pipe) for conditions like Achalasia Cardia(Swallowing issue due to non-relaxation of the lower end of the food pipe). Pancreatic and Hepatobiliary Surgeries. Adrenalectomy (removal of the Adrenal gland for tumours). Neck Surgeries e.g Scarless Thyroidectomy(Thyroid gland removal). Urological Surgeries(Radical Prostatectomy-is the most common Robotic Surgery) and Gynecological surgeries.

No, the Surgical Robot cannot and does not operate independently of the Surgeon. Current Robotic Technology is based on the “Master and Slave” Principle, where the Surgeon is the complete “Master” and the “Robot” is the absolute slave, incapable of doing any step without the Surgeon. In effect the Robot is a very high-tech extension of the Surgeon’s hands and fingers.