[caption id="attachment_13362" align="alignleft" width="328" caption="Ernie Sims runs out of the tunnel in Philadelphia. (Chris Chambers/Getty Images)"][/caption] Earlier this week, it was announced that Colts LB Ernie Sims had undergone an appendectomy over the weekend. Coltzilla takes a look at the nature of this type of surgery and what it means for his return to the field. The appendix sits at the end of the right-hand side of the colon; its purpose is not clearly known. An appendectomy (removal of the appendix) is an emergency surgery required for appendicitis, inflammation or bursting of the appendix. The symptoms can vary from flu-like symptoms (nausea, vomiting, general melaise) to acute pain. An inflamed appendix is likely to burst, which would quickly spread infection through the bowels and almost certainly result in death. Due to this risk, an appendectomy is usually performed whenever anyone suffers from appendicits.
It's hard to know whether Sims' appendix had already burst by the time he had surgery - by all accounts he played (and played well) just the day before. It could be that he suffered the appendicitis as a result of a big hit in practice, or that life just happens and he started to feel ill that night or the next morning. Either way, we know that he had surgery within several hours of having symptoms, so he either recognized the symptoms or the pain was acute enough for him to seek medical help. Removal is usually performed via laparoscopic surgery, which is the gastrointestinal equivalent of arthroscopic surgery. This means that a few small incisions were made to insert the instruments required to remove the appendix. If the appendix had already burst, the surgeon may have had to perform the more invasive open laparotomy to prevent the spread of infection. Based on my personal knowledge of this surgery, the key milestone he faces right now is to be able to "get things moving" again - while an appendectomy is a routine surgery, it's also quite disruptive to the bowels. The other key is to monitor that there is no infection; a post-surgery abcsess could set him back another day or two. Most people return to full function within 4-8 weeks, but some return more quickly. In 2010, Chiefs QB Matt Cassel returned just 11 days following an appendectomy to throw for 184 yards against St. Louis. Steelers' QB Ben Roethlisberger had a similar experience in 2006, sitting out 2 weeks and missing the home opener against Miami before jumping back in against Jacksonville. While it is still several weeks away from the regular season, and it is tempting to not rush Sims, he will likely want to be on the field sooner so as to earn a roster spot. Look for him to be participating in light practices by Pre-season Week 3, with a stretch goal of playing a bit against the Bengals in the final pre-season game.