Exploratory Laparotomy (Abdominal Exploration; Laparotomy, Exploratory)

Pronounced: LAP-uh-ROT-uh-mee

Definition

A laparotomy is a surgery of the abdomen. There are two types:

  • Open procedurerequires a standard surgical incision
  • Endoscopic (or laparoscopy)done through small, key hole incisions that are used to insert tools to see the abdomen and manipulate organs; gallbladder removal and tubal ligation can also be done this way

Parts of the Body Involved

  • Abdomen

Reasons for Procedure

A laparotomy is a diagnostic procedure to assess disease in the abdomen. The procedure is done to:

Depending on the condition, surgery may be done right away.

Risk Factors for Complications During the Procedure

The procedure itself has minimum risk. Your health and underlying disease will determine your risk.

What to Expect

Prior to Procedure

Exploratory laparotomy is not as common now. Other, less invasive choices are available. These include ultrasound , CT-scan , MRI, and catheter-guided, x-ray procedures.

Unless it is an emergency, the doctor will thoroughly evaluate you before the laparotomy. Anesthesia General anesthesia (almost always used) Local or spinal anesthesia (used in very ill patients) Description of the Procedure You will be given anesthesia and your stomach will be scrubbed. Once you are asleep, the surgeon will make either one long incision (open procedure) or several small ones (laparoscopy). During an open procedure, the abdominal organs will be carefully examined for disease. During laparoscopy, organs that might have disease will be explored. The doctor will examine you using the tools that have been passed through the incisions. A television will be used to project the images. The surgeon may take samples (biopsies) from suspicious areas. These will then be sent to the lab. In some cases, the surgeon may need to perform another procedure. After Procedure You may need more surgery depending on your diagnosis. How Long Will It Take? 1-4 hours (depending on how hard it is to make a diagnosis) Will It Hurt? There will be some pain after the procedure, but you can take pain medication. If you have spinal or local anesthesia, there may be pain during the procedure. The anesthesiologist (doctor who gives anesthesia) will give you more medication.
Possible Complications Bleeding, infection, and drug reactions are the most common side effects. If you do not need more surgery, then the risks are minimal and based on your disease. Average Hospital Stay Open laparotomyseveral days in the hospital Laparoscopicseveral hours Depending on your condition, you may need to stay in the hospital longer. Postoperative Care You will need to watch for complications and take several days to recover. The sutures or staples will be removed in 7-10 days. Outcome Your outcome will depend on your diagnosis. Call Your Doctor If Any of the Following Occurs Bleeding or discharge from the incisions Fever Increasing pain or pain that doesn't go away Nausea or vomiting Constipation beyond the first few days Pain or swelling in your legs Cough or difficulty breathing Pain or difficulty with urination RESOURCES: American Cancer Society http://www.cancer.org/docroot/home/index.asp/ National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/index.htm/ CANADIAN RESOURCES: BC Health Guide http://www.bchealthguide.org/ Canadian Digestive Health Foundation
http://www.cdhf.ca/ References: Abdominal exploration. MedlinePlus Medical Encyclopedia website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/002928.htm. Accessed September 8, 2005. Laparoscopic surgery. Women's Surgery Group website. Available at: http://www.womenssurgerygroup.com/treatments/laparoscopic.asp. Accessed September 22, 2005. Testing biopsy and cytology specimens for cancer. American Cancer Society website. Available at: http://www.cancer.org/docroot/ped/content/ped_2_3x_testing_biopsy_and_cytology_specimens_for_cancer.asp?sitearea=ped. Updated December 2007. Accessed June 5, 2008. Last reviewed November 2007 by Daus Mahnke, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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