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What are the indications for laparoscopic appendectomy?

Nov 05, 2025 Source: Cainiu Health
Dr. Huang Yuhong
Introduction
Indications for laparoscopic appendectomy generally include acute simple appendicitis, acute suppurative appendicitis, acute exacerbation of chronic appendicitis, appendicitis in obese patients, and appendicitis suspected of being associated with other intra-abdominal diseases. In cases of acute simple appendicitis without perforation or abscess formation, laparoscopic surgery allows precise localization and removal of the appendix with minimal trauma, reduced bleeding, and rapid postoperative recovery.

Laparoscopic appendectomy is generally indicated for acute simple appendicitis, acute suppurative appendicitis, acute exacerbation of chronic appendicitis, appendicitis in obese patients, and appendicitis suspected of being associated with other intra-abdominal diseases. A detailed analysis is as follows:

1. Acute Simple Appendicitis: In this condition, inflammation of the appendix is mild without perforation or abscess formation. Laparoscopic surgery allows precise localization and removal of the appendix with minimal trauma, less bleeding, and rapid postoperative recovery. It effectively reduces the risk of incisional infection and is suitable for patients with early-stage inflammation.

2. Acute Suppurative Appendicitis: The appendix shows pus formation but has not yet perforated, and intra-abdominal inflammation remains localized. Laparoscopy enables clear visualization of the abdominal cavity, thorough removal of pus, and prevention of inflammatory spread. It also avoids the larger trauma associated with open surgery and results in milder postoperative pain.

3. Acute Exacerbation of Chronic Appendicitis: Patients have a history of recurrent right lower abdominal pain that has acutely worsened. Laparoscopic surgery can clearly assess the pathological changes in the appendix, remove the diseased tissue, and result in a lower incidence of postoperative adhesions. This helps prevent recurrence and improves the patient’s quality of life.

4. Appendicitis in Obese Patients: Obese individuals have thick abdominal fat layers, making open surgery challenging due to large incisions and limited visibility. Additionally, wound healing is difficult and infection risk is high after open procedures. Laparoscopic surgery requires only small incisions, minimizes damage to the fatty layer, and reduces the incidence of postoperative complications.

5. Appendicitis Suspected of Coexisting with Other Abdominal Diseases: In addition to symptoms of appendicitis, patients may have other intra-abdominal abnormalities such as pelvic inflammatory disease or intestinal adhesions. Laparoscopy allows comprehensive exploration of the abdominal cavity to confirm or rule out concurrent conditions, enabling simultaneous appendectomy and treatment of other identified pathologies.

When symptoms such as right lower abdominal pain suggest appendicitis, prompt medical evaluation is essential for accurate diagnosis. After surgery, patients should follow medical advice regarding wound care and dietary adjustments, engage in appropriate activity to promote recovery of bowel function, and attend regular follow-up visits to ensure proper wound healing.

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What is appendicitis that is extremely prone to perforation?
Gangrenous appendicitis usually develops from simple appendicitis or suppurative appendicitis. Persistent and worsening obstruction within the appendiceal lumen leads to massive bacterial proliferation and toxin production, resulting in vascular thrombosis, ischemia, and necrosis of the appendix wall. The entire wall—ranging from the mucosal to the serosal layer—is affected, becoming fragile and losing normal elasticity, making perforation highly likely under intraluminal pressure.
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Dr. Huang Yuhong
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What are the complications of appendectomy surgery?
In general, as a common treatment for appendicitis, appendectomy may lead to complications including wound infection, intra-abdominal hemorrhage, intra-abdominal abscess, intestinal adhesions, and residual appendicitis. After surgery, patients should follow medical advice for wound care, engage in early appropriate activity to reduce the risk of intestinal adhesions, and closely monitor body temperature, abdominal pain, and bowel movements.
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Dr. Wang Lei
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Where is the surgical site for appendicitis?
In most cases, the surgical site for appendicitis is located in the right lower abdomen, specifically at the junction of the outer and middle one-third of the line connecting the umbilicus and the right anterior superior iliac spine (McBurney's point). If pain in the right lower abdomen worsens, prompt medical attention is recommended. Anatomically, the appendix is situated at the junction of the ileum and cecum in the right lower abdomen, and its surface projection corresponds to McBurney's point. In most cases of appendicitis, this area exhibits significant tenderness.
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Dr. Huang Yuhong
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What are the complications after appendectomy?
In general, although appendectomy is a common surgical procedure, it may still lead to certain postoperative complications, including incision infection or pain, intestinal adhesions, stump appendicitis, pelvic abscess, and gastrointestinal dysfunction. After surgery, patients should pay attention to wound care, get out of bed and move as early as possible to reduce the risk of intestinal adhesions, and maintain a light diet, avoiding overeating and binge eating.
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Dr. Wang Lei
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Does getting anesthesia hurt during appendicitis surgery?
In general, whether anesthesia for appendectomy causes pain depends on the type of anesthesia used. Local anesthesia may cause mild discomfort, while general anesthesia usually involves no significant pain. After surgery, it is important to keep the incision clean and dry to prevent infection. Initially, patients should eat light and easily digestible foods, gradually returning to a normal diet. Appropriate physical activity can be resumed according to individual recovery progress.
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Dr. Wang Lei
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Does appendicitis affect digestion?
In general, whether appendicitis affects digestion depends on the disease status. Digestion is usually affected during an episode of appendicitis; however, if the condition is not active and there are no obvious symptoms, normal digestive function is generally unaffected. It is important in daily life to maintain regular eating habits, avoid overeating, reduce intake of spicy, raw, or cold foods, minimize gastrointestinal irritation, and thereby indirectly lower the risk of appendicitis attacks.
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Can patients with appendicitis eat tofu?
In general, patients with appendicitis can eat tofu, as long as they do so in moderation. When consuming tofu, attention should be paid to the cooking method—opt for light preparations such as steaming, boiling, or stewing, and avoid heavy flavors like frying, spicy, or numbing seasonings that may irritate the intestines. During an acute flare-up of appendicitis accompanied by severe abdominal pain, nausea, or vomiting, fasting is recommended temporarily. Once symptoms subside, tofu can be gradually reintroduced into the diet.
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Can you eat seafood after appendicitis surgery?
In general, whether seafood can be consumed after appendectomy depends on the individual patient's postoperative recovery. When eating seafood, start with a small amount and monitor for any adverse reactions such as rashes or diarrhea. Postoperative diet should follow the principle of gradual progression—beginning with liquid or semi-liquid foods and slowly transitioning to regular meals. Avoid consuming spoiled or un新鲜 seafood.
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Dr. Wang Lei
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