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Laparotomy

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Alaparotomyisasurgicalincision(cut)intotheabdominalcavity.Thisoperationisperformedto
examinetheabdominalorgansandaiddiagnosisofanyproblems,includingabdominalpain.In
manycases,theproblemonceidentifiedcanbefixedduringthelaparotomy.Inothercases,a
secondoperationisrequired.Anothernameforlaparotomyisabdominalexploration.

Surgical investigation of abdominal pain

Acommonreasonforalaparotomyistoinvestigateabdominalpain,buttheproceduremaybe
requiredforabroadrangeofindications.Theabdominalorgansincludethedigestivetract(suchas
thestomach,liverandintestines)andtheorgansofexcretion(suchasthekidneysandbladder).
Yoursurgeonmayneedtooperatetofindouttheexactcauseofyourcomplaint.Forexample,
theymayneedtopinpointthecauseofinternalbleedinginthedigestivetractorfindoutwhere
yourbowelmaybeperforated(burst),beforetreatmentcancommence.

Medical issues to consider

Beforeyouroperation,yourdoctororsurgeonwill:

Askaboutyourmedicalandsurgicalhistoryandanylifestylefactors(suchascurrent
medications,orhistoryofsmoking)thatmayaffectyouroperation
Explaintheoperationanddiscusswithyouthepossibilityoffurthersurgeryoncethe
diagnosisismade
Informyouaboutanyproceduresleadinguptotheoperation(pre-operative)andwhatto
expectfollowingtheoperation.Youwillbeaskedtoconsenttotheoperation
Conducttestslikex-raysandbloodtests.

Immediately before the operation

Beforetheoperation,youcanexpect:

Youwillbeshavedintheabdominalarea.
Youmaybegivenasurgicalscrublotiontouseintheshowerandatheatregowntowear.
Youmaybegivenanenemaorsomeotherformofbowelpreparationtohelpemptyyour
bowels.
Ananaesthetistwillcheckthatyouarefitfortheoperationandtakenoteofanyallergies
youmayhave.
Youwillhavenilbymouth(nothingtoeat)foranumberofhoursbeforehand.

Laparotomy procedure
Alaparotomyisperformedundergeneralanaesthesia.Thesurgeonmakesasinglecutthroughthe
skinandmuscleoftheabdomen,sothattheunderlyingorganscanbeclearlyviewed.Theexposed
organsarethencarefullyexamined.Oncediagnosed,theproblemmaybefixedonthespot(for
example,aperforatedbowelmayberepaired).Inothercases,asecondoperationmaybeneeded.
Oncethelaparotomyiscomplete,themuscleoftheabdominalwallandtheoverlyingskinare
sutured(sewn)closed.

Immediately after the operation

Aftertheoperation,youcanexpect:

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Yourtemperature,pulse,respiration,bloodpressureandwoundsitearecarefully
monitored.
Youmayhaveadraininsertedatthewoundsite.
Asmalltubemayhavebeenpassedthroughyournoseandintoyourstomachtohelpdrain
stomachsecretionsforadayortwo.Thisrestsyourdigestivetractasitheals.
Aurinarycathetermaybeinsertedtodrainoffurine.
Youaregivenintravenousfluids(directlyintothevein),asyoumaynotbeallowedtoeat
forafewdays.
Painreliefshouldbegivenregularly,asorderedbyyourdoctor,tokeepyoucomfortable.
Assoonaspossible,youareencouragedtodoyourdeepbreathingandlegexercises.
Youareassistedoutofbedthedayaftertheoperation(allgoingwell).Earlywalkingis
important,asitreducestherisksofbloodclotsandchestinfections.
Youaregivendailywoundcareandobservation,alongwithadviceoncaringforyour
woundathome.
Medicationisgiventoyouondischarge.

Possible complications
Possiblecomplicationsoflaparotomyinclude:

Haemorrhage(bleeding)
Infection
Damagetointernalorgans
Formationofinternalscartissue(adhesions)
Bowelblockagesorabdominalpain,whichmaybecausedbyadhesions.

Taking care of yourself at home

Beguidedbyyourdoctor,butgeneralsuggestionsinclude:

Trytorestasmuchaspossiblefortwoweeks.
Arrangementsshouldbemadeforrelativesorfriendstohelpyouaroundthehouse.You
needtostrictlyavoidanyheavylifting,pullingorpushing.
Youmayneedamodifieddietfollowingdischargefromhospital.Followalldietary
suggestions.
Makesureyoutakeyourmedicationsandfollowinstructionsprecisely.
Continuewithanyexercisesyouwereshowninhospital.
Reporttoyourdoctorimmediatelyifyourwoundbecomesinflamed,tenderorstartsto
discharge.Thesesymptomscouldindicateinfection.

Long-term outlook
Recuperationtimefollowinglaparotomyisusuallysixweeks,butmayvarydependingonwhether
otherproceduresareperformedatthesametime.Aswithanypost-operativerecovery,itis
importanttoalwaysconsultyourdoctor.Makesureyouhaveafinalcheck-up.

Other forms of diagnosis

Analternativetolaparotomyislaparoscopy,orkeyholesurgery.Laparoscopyexaminestheinside
oftheabdominalorpelviccavityusingaslendertube(laparoscope)insertedthroughasmall
incision(cut).Thelaparoscopecontainsfibre-opticcameraheadsorsurgicalheads(orboth).
Beforelaparoscopywasavailable,doctorsalwayshadtomakelargeopeningsandcutthrough
layersoftissueinordertoexamineinternalorgans.Laparoscopygreatlyreducesthepatients
recoverytime,butisnotappropriateinallcases.

Where to get help

Yourdoctor
Surgeon

Things to remember

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Alaparotomyisasurgicalincisionintotheabdominalcavity.
Alaparotomyisperformedtoexaminetheabdominalorgansandaiddiagnosisofany
problems.
Possiblecomplicationsincludeinfectionandtheformationofscartissuewithinthe
abdominalcavity.
Analternativetolaparotomyislaparoscopy(keyholesurgery),wheresmallincisionsare
madethroughwhichtoexploretheabdominalcavity.Recoverytimeisgreatlyreduced
withthismethod.

This page has been produced in consultation with, and approved by:

CabriniMonashUniversity-DepartmentofSurgery
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