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Quick Response, Minimal Surgery, Brings Smooth Appendectomy

Quick response followed by minimally invasive surgery leads to a smooth appendectomy

While visiting family in Lincoln City this fall, 16-year-old Anthony Palacios of Dallas experienced an upset stomach and what he describes as a “stabbing pain” in the right side of his abdomen. His parents took him to the emergency room at Samaritan North Lincoln Hospital where he was quickly diagnosed with appendicitis and taken into surgery.

Lincoln City surgeon Arun Raman, who performed the appendectomy, credits Palacios’ family with getting him to the hospital early.

“Had they waited another 24 to 48 hours, the appendix likely would have ruptured, causing more pain, a longer hospital stay and a longer recovery,” said Raman. “Patients usually go home the day after surgery if the appendix hasn’t ruptured, but might need to stay in the hospital for three to five days after surgery if the appendix has ruptured. In fact, overall recovery for an inflamed appendix without rupture is usually less than one week, but a ruptured appendix might involve a recovery spanning several weeks.”

Raman performed the surgery laparoscopically, which involves the insertion of small, long tubes with a camera and tiny surgical instruments into the abdomen through three tiny incisions. The camera allows the surgeon to see the inside of the abdomen while performing the surgery via a television monitor.

“A few decades ago, all appendectomies were performed via an incision of about two to five inches in length,” said Raman. “Now, we’ve moved to this minimally invasive approach, which we believe results in quicker recovery for patients and less postoperative pain.”

Another advantage of the minimally invasive approach, said Raman, is that the use of cameras allow the surgeon to see more of the abdomen.

“When you make a traditional incision, all you can easily see is what is beneath the incision. Using a camera we’re able to view all of the intestines allowing us to see what’s going on and look for other potential problems.”

Raman noted this is especially important for women, since many health issues, including ovarian cysts, can mimic appendicitis.

While minimally invasive surgery is increasingly the norm, Raman said traditional open surgery is still done if surgeons believe the appendix will be especially difficult to remove, for example, if the appendix had already ruptured.

Like most patients who undergo laparoscopic appendectomies, Palacios was home within 24 hours of his surgery, and back to normal activity within a week. He reports that he is back to his old self and feeling great. And his family credits the care from Raman and the team at Samaritan North Lincoln Hospital with getting Palacios healthy and on the road to recovery quickly.

“The care and service we received at the hospital was top notch,” said Palacios’ father, Mike Link. “Dr. Raman was excellent and did a great job explaining what we could expect throughout the process. That team really has their act together.”

Raman encourages others to act quickly, like Palacios’ family, and not put off seeking medical help.

“If you’re experiencing excruciating pain on the right side of the abdomen above and beyond what you’ve ever felt before, along with a loss of appetite, go to the ER immediately,” said Raman. “The earlier we can get you diagnosed and treated, the quicker we can get you on the road to recovery.”