The appendix is a slender tube that comes off the first portion of the colon (cecum).  Despite being a well-known structure amongst physicians and lay persons alike its purpose is not well understood.  In children and adolescents the appendix harbors a number of lymphocytes (immune cells) and may be important in immunologic development.  Over time the number of lymphocytes appears to diminish and possibly its immunologic importance.

Also well known is the propensity for the appendix to become obstructed, acutely swollen and inflamed and this is what is referred to as appendicitis.  If the inflammation progresses the appendix can perforate or “burst” leading to severe infections within the abdominal cavity.

Surgery

Appendicitis has generally been considered a surgical emergency.  Removal of the appendix has been routinely performed through an open right lower quadrant incision over the last century.  There has been a growing trend to perform appendectomies using a laparoscopic approach.  Laparoscopic appendectomy is increasingly being performed for perforated appendicitis.  The laparoscopic approach, once considered an absolute contraindication for perforated appendicitis, has now been shown to reduce post-operative wound infections and hernias.   In addition, better pain control and earlier return to activity and work has also been demonstrated for laparoscopic appendectomy.