During the traditional, or open, appendectomy procedure, an incision two to three inches long is made in the right lower abdomen several inches above the hip bone. The incision opens both the skin and divides the abdominal muscle tissue, allowing the surgeon to see the appendix and pull it closer to the surface for better access.
Once the appendix is identified, it is cut away from the surrounding tissue, including the intestine, and infected tissue is removed. The opening that is left after the appendix is removed is closed by surgical staples or by sewing the area closed.
The appendix and surrounding tissues are then closely inspected to make sure the infection is isolated to the tissue that has been removed. If necessary, the surgeon can use sterile fluid to wash the area and then suction out any evidence of pus. If the surrounding tissues are healthy, the surgeon can begin to close the incision by first sewing the layers of muscle together, then closing the skin with stitches or staples.
The incision will be covered with a sterile bandage to protect the skin and prevent infection. The procedure, from the initiation of anesthesia to bandaging, takes less than an hour if there are no complications.
