Appendix removal (appendicectomy (appendectomy))

An operation, usually by keyhole surgery, to remove an inflamed appendix and treat appendicitis, most often done as an emergency.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

It is an operation to remove an inflamed appendix and treat appendicitis, usually as an emergency.
Keyhole surgery is most common, with smaller wounds and quicker recovery than open surgery.
If the appendix has burst, surgery is bigger and recovery and infection risk are higher.
After surgery, increasing pain, fever or a swollen tummy can mean infection and needs prompt review.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeSurgical operation

AnaestheticGeneral anaesthetic

How long it takesUsually under an hour

Hospital stayOften 1–2 nights; longer if the appendix has burst

Time off workAbout 1–3 weeks; longer after open or complicated surgery

When you'll see resultsTummy pain usually settles within days; full recovery over weeks

On the NHS?Almost always done on the NHS as emergency care; rarely a private elective

A general guide. Your surgeon will give you advice for your situation.

Best fit

Treats appendicitis and relieves the tummy pain it causes.

Pause if

You are too unwell for a general anaesthetic, where antibiotics or drainage may be used first.

Main recovery point

You stay in hospital, take pain relief and start eating and drinking again. Shoulder-tip and tummy discomfort from gas is common after keyhole surgery.

Good aftercare

Clear written warning signs for infection, abscess and blood clots, with a named contact route.

First 1–2 days

You stay in hospital, take pain relief and start eating and drinking again. Shoulder-tip and tummy discomfort from...

First week

Soreness eases and you build up gentle activity. Many people manage light activity within a few days, depending on...

Weeks 1–3

Most people return to desk work and normal daily life. Avoid heavy lifting and strenuous exercise until your...

Up to 6 weeks (open or burst appendix)

After open surgery or a burst appendix, full recovery takes longer, and you may need a longer course of...

Medical line illustration of keyhole abdominal surgery port placement for Appendix removal. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is appendix removal (appendicectomy)?

The appendix is a small, finger-shaped pouch that comes off the large bowel in the lower right tummy. Appendicitis is when it becomes inflamed, usually causing tummy pain, feeling sick and a raised temperature. It can be serious if the appendix bursts.

Appendix removal (appendicectomy) is an operation to take out the inflamed appendix. It is most often an emergency, done under general anaesthetic, usually by keyhole (laparoscopic) surgery through small cuts, or sometimes by open surgery through one larger cut.

Removing the appendix treats appendicitis and prevents it happening again. The appendix has no function you need to keep, so there are no long-term effects from losing it.

This is usually urgent surgery for a painful, potentially serious condition. There is sometimes a choice about timing or, for some people, treating with antibiotics first, which is worth discussing where time allows.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Keyhole (laparoscopic) appendicectomy

Several small cuts are used with a camera to remove the appendix. Most common, with less wound infection and a quicker recovery than open surgery.

Open appendicectomy

One larger cut in the lower right tummy. Used if the appendix has burst, if there is a lot of infection, or if keyhole surgery is not suitable or safe.

Conversion to open surgery

Keyhole surgery is sometimes changed to open surgery during the operation if it is safer or the view is difficult.

Antibiotics first (selected cases)

Some people with uncomplicated appendicitis are treated with antibiotics, with or without later surgery, especially if surgery is risky for them.

Drainage then delayed surgery

If a lump (mass) or abscess has formed, a drain may be placed first and the appendix removed later, once the inflammation has settled.

Keyhole versus open surgery

Point	Keyhole	Open
Cuts	Several small cuts	One larger cut
Wound infection	Lower	Higher
Recovery	Usually quicker	Usually slower
When used	Most cases	Burst appendix or difficult cases

Keyhole surgery suits most people, but open surgery is sometimes safer, especially if the appendix has burst. The surgeon decides during the operation if a change is needed.

Preparing for your surgery

Because this is usually an emergency, there is often little time to prepare; the team will explain things quickly.
You will not eat or drink before surgery so you are safe for a general anaesthetic.
Tell the team about all medicines, especially blood thinners, allergies and any health conditions.
You will usually be given fluids and pain relief, and sometimes antibiotics, before surgery.
Ask whether keyhole or open surgery is planned and what happens if the appendix has burst.
Arrange for someone to take you home when discharged and to help for the first days.
If surgery is planned rather than emergency, follow the fasting instructions you are given.

What happens

Once appendicitis is diagnosed or strongly suspected, you are prepared for surgery, usually quickly. The operation is done under general anaesthetic, so you are asleep.

In keyhole surgery, the surgeon makes a few small cuts, inflates the tummy with gas, and removes the appendix using a camera and instruments. In open surgery, one larger cut is made in the lower right tummy. If the appendix has burst, the surgeon also washes out the tummy and may leave a drain.

The operation usually takes under an hour but can be longer if the appendix has burst or there are complications. Most people stay one or two nights, longer if the appendix burst or if antibiotics through a drip are needed.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

You are too unwell for a general anaesthetic, where antibiotics or drainage may be used first.
Imaging suggests a different cause for the pain that needs a different treatment.
An appendix mass or abscess has formed, where draining and delayed surgery may be safer than operating immediately.
Surgery offers little benefit, for example where another condition explains the symptoms.

Delay surgery if…

There is an appendix mass or abscess that is better drained first and removed later.
You are stable enough that a short period of assessment or imaging will clarify the diagnosis.
Blood-thinning medicines or other conditions need urgent attention before anaesthetic.
Antibiotics-first treatment has been chosen for uncomplicated appendicitis in a higher-risk patient.

Alternatives to discuss

Antibiotics alone for selected uncomplicated appendicitis, accepting it may recur.
Drainage of an abscess followed by delayed surgery (interval appendicectomy).
Observation with repeated assessment and imaging where the diagnosis is unclear.
Treating a different cause if the pain is not from appendicitis.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

General anaesthetic

Always used for appendix removal; you are fully asleep throughout.

Benefits

Treats appendicitis and relieves the tummy pain it causes.
Prevents the appendix bursting if done before that happens.
Stops appendicitis happening again, as the appendix is removed.
Lets the surgeon check the diagnosis and deal with anything else found.

Risks & complications

More common

Pain, bruising and swelling around the wounds for a week or two
Tiredness and feeling washed out for a week or two
Temporary bloating, wind and a slow return of normal bowel habit
Shoulder-tip discomfort from the gas used in keyhole surgery

Less common

Wound infection, more likely after open surgery or a burst appendix
A collection of pus (abscess) inside the tummy, especially if the appendix burst
Temporarily sluggish bowels (ileus) needing a longer stay
Keyhole surgery being changed to open surgery

Rare but serious

Injury to the bowel, bladder, blood vessels or other structures
Bleeding needing further treatment
Blood clot in the leg or lung, or a chest infection
A hernia at a wound site later, or finding a normal appendix (negative appendicectomy)

The biggest factor is whether the appendix has burst. A burst (perforated) appendix means a bigger operation, a higher chance of infection or abscess, and a longer recovery. Delaying treatment raises the chance of this happening. Ask your surgeon what they expect to find, whether keyhole or open surgery is planned, and what the recovery is likely to be.

Published figures to discuss

Risks depend most on whether the appendix has burst and on your general health. Keyhole surgery lowers wound infection compared with open surgery but can slightly raise the chance of an internal abscess in adults. The figures below are broad ranges from trials and reviews, not promises for any individual.

Figure	Reported range	How to interpret it	Source / confidence
Wound infection	Lower after keyhole than open surgery; often a few percent after laparoscopic surgery and up to low double digits after open or perforated cases	Higher if the appendix has burst.	Infectious complications following laparoscopic appendectomy — Canadian Journal of Surgerycanjsurg.caSource-linked context
Abscess inside the tummy	Usually low single figures after uncomplicated appendicitis, but can reach around 10% or more after perforated appendicitis	May need antibiotics or drainage.	Infectious complications following laparoscopic appendectomy — Canadian Journal of Surgerycanjsurg.caPublished figure
Keyhole surgery changed to open	A minority, often a few percent in modern series; higher with perforation, abscess, obesity or difficult anatomy	A safety decision made during the operation, not a failure.	Infectious complications following laparoscopic appendectomy — Canadian Journal of Surgerycanjsurg.caSource-linked context
Normal appendix removed (negative appendicectomy)	Now usually low-to-mid single digits in well-imaged adults, but higher in some groups and emergency settings	Imaging beforehand can reduce, but not eliminate, this.	Infectious complications following laparoscopic appendectomy — Canadian Journal of Surgerycanjsurg.caPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Most people recover from a straightforward keyhole appendicectomy within one to three weeks. Recovery is slower after open surgery or if the appendix has burst.

First 1–2 days

You stay in hospital, take pain relief and start eating and drinking again. Shoulder-tip and tummy discomfort from gas is common after keyhole surgery.

First week

Soreness eases and you build up gentle activity. Many people manage light activity within a few days, depending on how unwell they were.

Weeks 1–3

Most people return to desk work and normal daily life. Avoid heavy lifting and strenuous exercise until your surgeon agrees.

Up to 6 weeks (open or burst appendix)

After open surgery or a burst appendix, full recovery takes longer, and you may need a longer course of antibiotics and closer follow-up.

What's normal — and not a worry

Soreness around the wounds, easing over one to two weeks
Tiredness and reduced appetite for a short time
Bloating, wind and a slow return to normal bowel habit
Shoulder-tip discomfort from the gas used during keyhole surgery

Aftercare

Take regular pain relief as advised for the first few days.
Keep the wounds clean and dry, and follow advice on dressings and showering.
Build up walking gently to reduce the risk of clots and chest problems.
Avoid heavy lifting and strenuous exercise until your team agrees.
Eat normally as your appetite returns, and stay hydrated.
Finish any prescribed antibiotics, especially after a burst appendix.
Do not drive until you can do an emergency stop comfortably and your team agrees.

Before-surgery checklist

Pain relief bought or prescribed
Any antibiotics collected and instructions understood
Lift home and help for the first few days arranged
Time off work or study booked
Loose, comfortable clothing ready
Clinic and out-of-hours contact numbers saved

Scars and how they heal

Keyhole surgery leaves a few small scars, usually including one at the belly button, which generally fade well. Open surgery leaves one larger scar in the lower right tummy. Scars can be firm or raised at first; sun protection helps them settle.

⚠ Get urgent help if…

Increasing or severe tummy pain rather than steadily improving
A high temperature, feeling shivery or generally very unwell
Increasing redness, heat, swelling or discharge from a wound
Being repeatedly sick, a swollen tummy, or not passing wind or stool
A red, hot, swollen or painful calf, or sudden breathlessness or chest pain
Bleeding that soaks through dressings and does not stop

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

For most people, removing the appendix settles the tummy pain within a few days and there are no long-term effects from losing the appendix. A straightforward keyhole operation usually means a quick recovery.

If the appendix had burst, recovery takes longer and there is a higher chance of an infection or abscess that needs further treatment. Occasionally the appendix is found to be normal, in which case the surgeon checks for other causes of the pain.

How long it lasts

Once the appendix is removed it cannot become inflamed again, so appendicitis does not come back. Rarely, a small remnant can cause problems, and wound hernias can develop later. There are no known long-term downsides to living without an appendix.

Combining with other procedures

Appendix removal is usually a single, focused operation. Occasionally, if the diagnosis was uncertain, the surgeon checks nearby organs during keyhole surgery and deals with anything clearly causing the symptoms. Major additional surgery would normally be discussed separately unless it is an emergency.

Follow-up & long-term care

Many people are given advice and discharged without a routine clinic visit after a straightforward operation. After a burst appendix, or if tissue is sent for testing, you may be reviewed and given results. Report increasing pain, fever or wound problems promptly rather than waiting.

Revision and secondary surgery reality

If an abscess forms, further treatment with antibiotics or drainage may be needed.
A burst appendix can mean a longer stay and a longer course of antibiotics.
A wound hernia can develop later and occasionally needs repair.
Rarely, a small remnant of appendix tissue causes problems needing further surgery.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

Clear written warning signs for infection, abscess and blood clots, with a named contact route.
Advice on pain relief, wound care, activity, lifting and returning to work or school.
Completion of any antibiotic course, with follow-up after a burst appendix.
A plan for reviewing any tissue test results and a route back if symptoms worsen.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether surgery is keyhole or open
Whether the appendix has burst and needs more treatment
Surgeon and anaesthetist fees
Theatre and facility costs, and the length of hospital stay
Antibiotics and any drain or extra procedures
Imaging and tests before and after surgery

Make sure your written quote includes

The surgeon's and anaesthetist's fees
Theatre, facility and hospital stay costs
Antibiotics, drains and any extra procedures
Imaging and tests included
Follow-up appointments and any tissue test results
The policy if a longer stay is needed for a burst appendix
What happens, and who pays, if there is a complication

On the NHS? Appendix removal is almost always provided on the NHS as emergency care when appendicitis is diagnosed; it is rarely a planned private operation.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Choosing a surgeon safely

Check your surgeon is on the GMC Specialist Register for this area.
Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

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Questions to ask your medical professional

Take this to your consultation. A good surgeon will welcome every one of these.

Do you expect keyhole or open surgery for me, and why?
What do you think you will find, and has my appendix likely burst?
Will I need antibiotics, and for how long?
How long is my recovery likely to be, and when can I return to work or school?
What are the chances of an abscess or wound infection afterwards?
What should make me seek urgent help after I go home?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the surgeon who carries out my operation, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this operation not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Can appendicitis be treated without surgery?

Sometimes. Some people with uncomplicated appendicitis are treated with antibiotics, especially if surgery is risky for them. But appendicitis can come back, and surgery is still the usual treatment. Your team will discuss what is safest for you.

Will losing my appendix affect me long term?

No. The appendix has no function you need to keep, and people live normally without it.

How soon can I go back to work or school?

After a straightforward keyhole operation, often within one to three weeks. Recovery is longer after open surgery or a burst appendix. Avoid heavy lifting until your team agrees.

What happens if my appendix has burst?

Surgery is bigger, the tummy is washed out, and you may need a drain and a longer course of antibiotics. Recovery takes longer and infection is more likely, so follow-up is closer.

What if the appendix turns out to be normal?

This is called a negative appendicectomy. The surgeon checks for other causes of the pain. Removing a normal-looking appendix is sometimes still done to prevent future doubt.

Is this done privately or only on the NHS?

It is almost always emergency care on the NHS. It is rarely a planned private operation, though private hospitals may treat it if appendicitis develops there.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Appendicitis Guy's and St Thomas' NHS — Appendicectomy (overview) Guy's and St Thomas' NHS — Recovery after an appendicectomy Laparoscopic versus open surgery for suspected appendicitis — Cochrane Appendectomy — StatPearls (NCBI Bookshelf) Infectious complications following laparoscopic appendectomy — Canadian Journal of Surgery Conversion from laparoscopic to open appendectomy: trends and outcomes

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.