What is it?
It is a surgical incision (cut) in the abdominal cavity. This operation is done to examine the abdominal organs and help diagnose any problem, including abdominal pain.
In many cases, the problem, once identified, can be corrected during laparotomy. In other cases, a second operation is required. Another name for laparotomy is abdominal examination.
Surgical investigation of abdominal pain
A common reason for a laparotomy is to investigate abdominal pain, but the procedure may be necessary for a wide range of indications.
The abdominal organs include the digestive tract (such as the stomach, liver, and intestines) and the organs of excretion (such as the kidneys and bladder). Your surgeon may need to operate to discover the exact cause of your complaint.
For example, they may need to identify the cause of the internal bleeding in the digestive tract or find out where the intestine can be perforated before treatment begins.
- Tell your doctor about any lifestyle factors (such as current medications or a history of smoking) that may affect your functioning.
- Your doctor will inform you about any procedure that leads to the operation (pre-operative) and what to expect after the operation. You will be asked to accept the operation legally.
- You will have tests like x-rays and blood tests.
Before the operation:
- You will be shaved in the abdominal area.
- You may be given a lotion for surgical scrubbing to use in the shower and a gown to wear.
- You may be given an enema or other form of bowel preparation to help empty your bowels.
- An anesthesiologist will verify that you are fit for the operation and will take note of any allergies you may have.
- You will not be able to eat anything for several hours before the procedure.
A laparotomy is performed under general anesthesia. The surgeon makes a unique cut through the skin and muscle of the abdomen, so that the underlying organs can be clearly seen.
The exposed organs are examined carefully. Once diagnosed, the problem can be fixed immediately (for example, a perforated bowel can be repaired). In other cases, a second operation may be necessary.
Once the laparotomy is completed, the muscle of the abdominal wall and the skin that covers it are sutured (sewn) and closed.
Immediately after the operation
- Your temperature, pulse, respiration, blood pressure and wound site are carefully monitored.
- You may have a drainage inserted into the wound site.
- It is possible that a small tube has been passed through the nose and stomach to help drain stomach secretions for a day or two. This rests in your digestive tract as you heal.
- A urinary catheter can be inserted to drain urine.
- Fluids are given intravenously (directly into the vein), as you may not be able to eat for a few days.
- As soon as possible, you are encouraged to do your deep breathing exercises and legs.
- They help you get out of bed the day after the operation (if all goes well). Early walking is important because it reduces the risks of blood clots and chest infections.
- You are given daily care and observation of the wound, along with advice on caring for your wound in the home.
Possible complications of laparotomy include:
- Hemorrhage (bleeding)
- Damage to internal organs.
- Formation of internal scar tissue.
- Intestinal blockages or abdominal pain, which can be caused by adhesions.
Be guided by your doctor, but general suggestions include:
- Try to rest as much as possible for two weeks.
- Arrangements should be made for family or friends to help you at home. You must strictly avoid lifting heavy objects, throwing or pushing.
- You may need a modified diet after discharge from the hospital. Follow all dietary suggestions.
- Be sure to take your medications and follow the instructions precisely.
- Continue with the exercises you were taught at the hospital.
- Tell your doctor immediately if your wound becomes inflamed, sensitive, or begins to peel. These symptoms can indicate an infection.
Recovery time after laparotomy is usually six weeks, but may vary depending on whether other procedures are performed at the same time.
As with any postoperative recovery, it is important to always consult your doctor. Make sure you have a final check.
Other forms of diagnosis
An alternative to laparotomy is laparoscopy, or “keyhole surgery.” Laparoscopy examines the inside of the abdominal or pelvic cavity with a thin tube (laparoscope) inserted through a small incision (cut).
The laparoscope contains fiber optic camera heads or surgical heads (or both). Before laparoscopy was available, doctors always had to make large openings and cut layers of tissue to examine the internal organs.
Laparoscopy greatly reduces the patient’s recovery time, but is not appropriate in all cases.