Laparoscopic appendectomy: an OR 101 guide
Reviewed by Rodnie Oro, cath lab charge nurse · Last reviewed: October 2026 · Education only, not medical advice
Lap appendectomy in one minute
What it is: keyhole surgery to remove an inflamed appendix (appendicitis).
Who it is for: people with appendicitis, usually as an urgent operation.
Main risks: wound or internal infection (abscess), bleeding, bowel injury (rare), conversion to open surgery.
Usually: under general anaesthetic, about 1 hour, home in 1–3 days.
On this page: What is a laparoscopic appendectomy? · Who is it for? · When is it done? · Step by step · Recovery · Risks · Kit list · First time in theatre? · FAQ
What is a laparoscopic appendectomy?
The appendix is a small finger-shaped tube attached to the start of the large bowel, low on the right side. When it becomes blocked and inflamed (appendicitis), it can burst and cause infection inside the abdomen.
In a laparoscopic appendectomy the surgeon:
- inflates the abdomen with gas and places a camera and two or three ports
- divides the appendix's blood supply with an energy device or clips
- closes the base with loops, staples or clips, per surgeon
- removes the appendix in a bag and washes out any pus
Some people with mild appendicitis are offered antibiotics instead; your team will discuss this.
New to the acronyms? See the Cath Lab Abbreviations A–Z.
Who is it for?
It may be considered for people with:
- appendicitis confirmed on examination, blood tests or scan
- suspected appendicitis where the diagnosis needs to be confirmed
- an abscess or burst appendix, sometimes after antibiotics
The decision is made by your surgical team, who will talk through the reasons, the alternatives and the risks with you.
When is it done?
It is usually done urgently, within hours to a day. Before it, you usually have:
- an examination and blood tests
- often an ultrasound or CT scan
- a pregnancy test for anyone who could be pregnant
- antibiotics, fluids and pain relief, as per centre protocol
- a chance to ask questions and give consent
Step by step
1. Getting ready
Team brief and WHO checklist first. The anaesthetic team and ODP give a general anaesthetic and insert a breathing tube; antibiotics and blood-clot prevention are given as per centre protocol. The circulating practitioner checks positioning, pressure areas, the diathermy plate, warming, and that the camera stack and gas insufflator work. The scrub practitioner sets up the laparoscopic trolley and an open set in case of conversion, and does the first count.
2. Access
The patient lies on their back, often tilted. A first port is placed at the belly button and gas is introduced; two more ports go low in the abdomen, sizes per device and operator.
3. Removing the appendix
- A. Gas and ports. The abdomen is inflated and the camera and ports placed.
- B. Find the appendix. The appendix is found and its blood supply divided.
- C. Base secured. The base is closed with loops, staples or clips and the appendix divided.
- D. Removed in a bag. The appendix is removed in a bag; pus is washed out if present.
4. Finishing
The gas is let out, ports removed and the larger cuts closed (deep layer, per surgeon), then the skin with sutures or glue. Local anaesthetic is often injected into the wounds. Final counts are confirmed, specimens labelled and checked, and the patient goes to recovery with a full handover.
Recovery and aftercare
- First hours: in recovery, then a ward or day unit; pain relief and anti-sickness medicine as needed.
- Going home: usually 1–3 days, longer if the appendix had burst.
- Activity: walking early; avoid heavy lifting for about 2 weeks; ask your team.
- Antibiotics: some people continue antibiotics after a burst appendix.
- Wounds: keep them clean and dry as advised; sutures or clips may need removing.
- Follow-up: clinic review or a phone call, as per centre protocol.
Call 999 if you have severe pain, heavy bleeding, breathlessness or collapse. Contact your team or GP if you have a fever, worsening tummy pain or swelling, vomiting, or a wound that becomes red, hot or leaky.
Risks and complications
Your team will explain the risks that apply to you. Possible problems include:
- wound infection or a collection of pus inside (abscess)
- bleeding
- injury to the bowel or bladder (rare)
- a slow-moving bowel (ileus) for a few days
- conversion to open surgery
- blood clots in the legs or lungs
Theatre kit list (printable)
Example kit list
Every theatre has its own protocol, and sizes and doses vary.
- laparoscopic stack: camera, scope, light source, gas insufflator and warmer
- ports, sizes per device and operator, and an entry needle or open-entry kit, per surgeon
- laparoscopic graspers, scissors, dissectors and suction-irrigation
- energy device, per surgeon
- loops, clips or stapler for the base, sizes per device and operator
- specimen retrieval bag
- suction-irrigation and warmed washout fluid
- closure sutures, local anaesthetic and dressings
Procedural steps
- Team brief, WHO sign in; anaesthesia; antibiotics as per centre protocol
- Supine position; catheter or empty bladder first, per centre protocol; prep and drape; count
- First port; gas; camera; two lower ports
- Appendix found; blood supply divided; base secured; appendix divided
- Bag; removal; washout if needed
- Gas out; closure; counts; specimen check; sign out and handover
First time in theatre?
đź’ˇ First-time tip
- Know your role. Scrub, circulating, anaesthetic and ODP each have their own checks; ask at the team brief.
- Counts matter. Swabs, needles and instruments are counted before, during and at closure; speak up if one is missing.
- Specimens. Label every specimen with site and side, and check it with the scrub practitioner before it leaves theatre.
- Camera ready. Learn to white-balance the camera and warm the scope to stop fogging.
- Open set ready. An open tray stays available in case keyhole surgery has to convert to open.
FAQ
Do I need my appendix?
No. People live normally without it.
Can antibiotics be used instead?
For some mild cases, yes. Your team will discuss the options.
How soon can I go back to work?
Often 1–2 weeks, longer for manual work or if the appendix burst.
Related guides
Sources
All checked on 14 October 2026. Each page's own date is shown where it gives one.
- NHS. Appendicitis. nhs.uk/conditions/appendicitis
- StatPearls (NCBI Bookshelf), search: appendectomy. ncbi.nlm.nih.gov/books
- Di Saverio S, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg 2020;15:27. PubMed 32295644
- World Health Organization. Surgical Safety Checklist. who.int
Disclaimer
Education only. This page is for general education for healthcare students, theatre staff and curious readers. It isn't medical advice and doesn't replace advice from your own doctor, surgical team or local unit protocols. Equipment and medicines are described generically. No product or manufacturer is recommended. If you think someone is having a medical emergency, call 999.
Disclosure: I work in the medical device industry. This page is independent education and isn't sponsored or reviewed by any company.
All diagrams on this page are original illustrations created for rodnieoro.com.
