Appendectomy - what category of surgeon performs these ?

[WildRosie]

Might seem a daft question but this operation strikes me as a sort of 'bread and butter' procedure. I know appendicitis falls into the general/colorectal category but is it necessarily one of those surgeons who gets the job or can anyone do it ? Given that most cases are likely to be emergencies there may not always be time to wait for the ideal medic to be available. My Mum had her appendix out as an emergency case in 1973 and she said it was a 'houseman' who did the job, probably known as a surgical registrar nowadays. I don't think he was a Consultant surgeon.

Of course, the rise of laparoscopic surgery and medical treatment as a first resort may blur the lines even further.

BTW, I don't want to find out the hard way!

It would be General surgery. Often will be junior dr who does it
However more often now appendicitis is being treated conservatively ie with antibiotics rather than surgery.

Thankyou Ghislaine. More or less what I expected.

Depends where you go, my local hospital is a centre of excellence for Europe for appendix cancer so all appendectomies are carried out by members of the appendix team who are separate to general surgery.

General surgery at my trust, normally if out of hours a general surgical registrar.

DD had hers appendix removed under an emergency. Two junior doctors performed it and I was very grateful. They took DD in five minutes before they were due to finish, operation took a while as area was badly infected and took a fair amount of flushing/cleaning. They were three hours late finishing and were still with her when she was coming around and also gave us an update.

I had mine out by a consultant, but that was Mother's Day 2020, just as the pandemic was ramping up and the registrars were tied up intubating people. I consider myself incredibly fortunate in so many ways, the way mine was handled.

My surgeon friend said its usually the first surgery that a student does. They observe one, assist on one, and then do one themselves. I find that quite scary!

As appendicitis is likely deeply unpleasant it's probably a good thing so many grades of medic can deal with it, from the most junior surgeons to the Professors. It does seem as though it's a 'baseline' operation. I once asked my GP if she could perform an appendectomy and she replied straight away that she was confident she could, adding it wasn't a difficult job.

Open appendectomies used to be done by house officers, (or even medical students, in the days when I was a young doc!), supervised by their registrar, but modern appendectomies are often performed via laparoscope (keyhole surgery) so require more specialist skills, which usually would be a surgical registrar.

According to Grey's anatomy interns on their first day. ;-D

More seriously I certainly believe it's done by a general surgeon.

General surgery in my trust. Consultation or most likely in an emergency on call registrar

Years ago they used to be done by the GP in the cottage hospital. Tonsillectomies, too.

Whoever's on rota, generally. I can vouch appendicitis is not a whole heap of fun.

A Houseman was a junior doctor - most likely on their first rotation. An F1 I think they're called now?

I had mine out in the very late 80s. It was taken out by the consultant as I worked at the hospital!

Oooh favouritism @Moonflower12 😄

A few years ago, a workmate of mine had his appendix out in the small hours, having been admitted to hospital several hours earlier (theatre was busy that night, apparently). He had actually developed peritonitis so couldn't have a keyhole removal but had a traditional incision and disinfection instead. I remember the consultant's name above his hospital bed but I doubted he did the job himself, given the godawful hour!

Judging by the size of my appendix scar mine was performed by a tree surgeon wielding a chain saw.

(Many years later I had my fibroids removed and the scars sort of meet at right angles, I really need a matching one on the left to complete the set, any offers? No organ removal required, just the incision and a bit of stitching. grin)

@iklboo
I was slightly weirded by the fact he had seen my ovaries as he once told me!

My appendix scar is quite large, a medic friend said they probably checkout my ovaries as I was 10 and had hit puberty and they were not actually sure if it was appendicitis.