My nephew had an emergency appendectomy on Wed, it was done by laparoscopy but the surgeon nicked it and it burst. As of 4pm today his vitals are good but has abdomen distension and they are watching the drainage tube for color change. Respiratory therapist comes every day to help w/ breathing and staving off pneumonia. Has anyone else here had any trouble w/ this kind of op? I thought it would be somewhat of a routine task. Any info would be nice, thanks guys.
Medical ? for the board
- Thread starter PaBoiler78
- Start date
Ask lots of questions. In a emergency situation they can’t take the time to explain everything beforehand but they owe your nephew a complete accounting of what they did.
thanx, wondering if any here had an appendectomy and what to expect afterwards.
I have no advice but just wanted to wish your nephew well and a fast recovery!
Unfortunately, sounds like a mistake to me. About two or three years ago I had 4 in of my colon removed by laparoscopic surgery. For 20 minutes after I got up I felt very minor pain. After that, I felt better than I did going in. Had absolutely zero problems.
Very sorry for your nephew's problems.
If the surgeon nicked the inflamed appendix it is not good as it could result is a serious infection throughout the abdomen and could even result in sepsis. I am sure they are following his condition closely and likely started him on antibiotics. They will monitor temp, blood pressure, white blood cell count and more. You or whoever is authorized should have a long talk with attending physician about all they are doing.
Am surprised they came right out and admitted he nicked the appendix. Things like this usually get covered up. Did they have to open him up to complete the procedure? Much longer recovery if so.
With modern care he should be fine but needs to be closely monitored.
(Not a doctor or nurse....just experienced)
Am surprised they came right out and admitted he nicked the appendix. Things like this usually get covered up. Did they have to open him up to complete the procedure? Much longer recovery if so.
With modern care he should be fine but needs to be closely monitored.
(Not a doctor or nurse....just experienced)
I had an appendectomy during the fall of my sophomore year at Penn State at Mountain View Hospital (Mt. Nittany Medical Center now). A pinpoint perforation of the appendix was found at the time of surgery. Whether it was spontaneous or related to handling of an enlarged and inflamed appendix was unknown. Because of the perforation I had to spend a longer time in the hospital and had a Penrose drain (surgical drain) put in during surgery in case of potential post-op infection of the surgical bed. Fortunately I had only sero-sanguinous drainage without development of any purulent drainage, so I could be discharged without an even more extended stay. I had an old fashioned open appendectomy because that was way before the advent of laparoscopic surgery.
Laparoscopic appendectomy is an entirely different animal because one is operating in a very tight space with specialized surgical instruments place through a tiny incision. The laparoscope provides a limited field of view compared to surgery with an open incision so it is technically more difficult to do and easier to cause minor injury to adjacent tissue because of operating in a tighter space with a more limited ability to see what is happening. Just handling or bumping an enlarged, inflamed and potentially very friable appendix can cause it to perforate (or be “nicked”). As stated above in my own experience, a pinpoint perforation requires the placement of a surgical drain to lessen the chance of developing a postoperative infection or abscess in the surgical bed. This is not an uncommon situation in surgical procedures. Post operative infections can also occur with seemingly uncomplicted surgeries as well. These sometimes require drainage procedures such as a percutaneously placed drainage catheter under imaging guidance.
So I would not go off the deep end and call this a mistake or negligence right off the bat without knowing more about the situation, as some here have proposed.
Laparoscopic appendectomy is an entirely different animal because one is operating in a very tight space with specialized surgical instruments place through a tiny incision. The laparoscope provides a limited field of view compared to surgery with an open incision so it is technically more difficult to do and easier to cause minor injury to adjacent tissue because of operating in a tighter space with a more limited ability to see what is happening. Just handling or bumping an enlarged, inflamed and potentially very friable appendix can cause it to perforate (or be “nicked”). As stated above in my own experience, a pinpoint perforation requires the placement of a surgical drain to lessen the chance of developing a postoperative infection or abscess in the surgical bed. This is not an uncommon situation in surgical procedures. Post operative infections can also occur with seemingly uncomplicted surgeries as well. These sometimes require drainage procedures such as a percutaneously placed drainage catheter under imaging guidance.
So I would not go off the deep end and call this a mistake or negligence right off the bat without knowing more about the situation, as some here have proposed.
Sorry Dr O. Didn’t mean to imply gross negligence. But the OP said ‘nicked’ so that is the term I used. Don’t know how serious a nick. Nor do I know the normal rate of incidental damage done during this procedure. Was just pointing out it could be serious but I am sure they are monitoring his condition closely and taking proper precautions.
One example is an orthopedic surgeon Harry Figgie who altered a document to protect himself in Cleveland. His father was the CEO of Figgie corporation which used to be a fairly large company before it went under. There is an Ohio supreme Court opinion which you can find with a simple internet search putting in the doctor's name and adding Ohio supreme Court.
As above. The handling properties of healthy tissue is usually predictable. But in really inflamed situations, the tissue can become like wet toilet paper. It is so friable , it just falls apart. It can also become scarred down or attached to adjacent things making it difficult to separate. In everyday life, sometimes tape or a wrapper just peels off, and sometimes it is voraciously attached. If it is in a surgery, this can lead to things above as described by O. It doesn't mean the surgeon was incompetent or careless.
As O said, I would not go off the deep end and call this a mistake or negligence right off the bat without knowing more about the situation, as some here have proposed.
Yes, there are good outcomes, not-so-good to bad outcomes, and bad outcomes due to negligence. Nicking an enflamed appendix during appendectomy is probably not negligent. Nicking it without realizing it, or just ignoring that you nicked it would be an issue. In someone who is otherwise healthy, this will probably just unfortunately extend their hospital stay a bit...
My mother had her appendix removed long ago when they opened you up. Dr told her just as he slipped a specimen pan under her appendix it ruptured. Lucky it didn’t do so prior or she may have died.
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