First of all, we don’t really need an appendix, which is why it is often removed as a precaution against future appendicitis during other abdominal surgery. However, appendectomy for appendicitis is still the most common surgery done by acute-care surgeons, and has been the mainstay for centuries for treating appendicitis. The first appendectomy was in 1735. In fact, ask any physician, surgeon or non-surgeon how to treat appendicitis and the universal answer will be, “cut it out.” But that response may be changing. Already in Europe several research trials have looked at the use of antibiotics for unruptured appendicitis. The rationale for these trials is that appendicitis is much akin to another intestinal malady – diverticulitis, which in most cases can be treated with antibiotics. In these trials 75% of the patients recovered without needing surgery. A large-scale, randomized trial is also underway in the U.S. If results are similar, it may give patients a new option — perhaps one especially useful for high-surgery-risk patients with appendicitis who have severe pulmonary or cardiovascular disease. So, if you see me in the ER at Tampa General and I’m calling for a surgeon for your acute appendicitis, don’t be afraid to ask me for a Plan B.