Tests, procedures and surgery

Exploratory laparotomy

(Abdominal Exploration; Laparotomy, Exploratory)

Exploratory laparotomy – Definition

Laparotomy – open surgery of the abdomen to view the organs and tissue inside.

Exploratory laparotomy – Reasons for Procedure

This procedure is done to evaluate problems in the abdomen.

Problems that may need to be examined with an exploratory laparotomy include:

  • A hole in the bowel wall
  • Ectopic (outside the womb) pregnancy
  • Endometriosis
  • Appendicitis
  • Damage to an organ from trauma
  • Infection in the abdomen
  • Cancer

Exploratory laparotomy – Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a laparotomy, your doctor will review a list of possible complications, which may include:

  • Bleeding
  • Infection
  • Blood clots
  • Damage to organs
  • Hernia formation
  • Large scars
  • Reaction to the anesthesia

Some factors that may increase the risk of complications include:

  • Previous abdominal surgery
  • Diabetes
  • Heart or lung disease
  • Weak immune system
  • Blood disorders
  • Taking certain medicines
  • Smoking, alcohol abuse, or drug use

Be sure to discuss these risks with your doctor before the procedure.

Exploratory laparotomy – What to Expect

Prior to Procedure

Leading up to your procedure:

  • Your doctor may perform the following:
    • Physical exam
    • Blood and urine tests
    • Ultrasound — a test that uses sound waves to visualize the inside of the body
    • Computed tomography (CT) scan — a type of x-ray that uses a computer to make pictures of the inside of the body
    • Magnetic resonance imaging (MRI) scan — a test that uses magnetic waves to make pictures of the inside of the body
  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Anti-inflammatory drugs (eg, aspirin)
    • Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)
  • Arrange for a ride home.
  • The night before, eat a light meal. Unless told otherwise by your doctor, do not eat or drink anything after midnight.

Exploratory laparotomy – Anesthesia

  • General anesthesia (almost always used) — blocks pain and keeps you asleep through the surgery; given through an IV in your hand or arm
  • Spinal anesthesia (used in very ill patients) — the area from the chest down to the legs is numbed

Exploratory laparotomy – Description of the Procedure

The doctor will make one long incision in the skin on your abdomen. The organs will be examined for disease. The doctor may take a biopsy. If the problem is something that can be repaired or removed, it will be done at this time. The opening will be closed using staples or stitches.

Exploratory laparotomy – How Long Will It Take?

About 1-4 hours

Exploratory laparotomy – How Much Will It Hurt?

Anesthesia will prevent pain during the procedure. For pain and soreness after surgery, you will get medicine.

Exploratory laparotomy – Average Hospital Stay

Several days — If you have problems, you may need to stay longer.

Exploratory laparotomy – Post-procedure Care

At the Hospital

  • You may need to wear special socks or boots to help prevent blood clots.
  • You may have a foley catheter for a short time to help you urinate.
  • You may use an incentive spirometer to help you breathe deeply.

At Home

It may take several weeks for you to recover.

  • Follow your doctor’s instructions.
  • The doctor will remove the sutures or staples in 7-10 days.
  • Take proper care of the incision site. This will help to prevent an infection.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • During the first two weeks, rest and avoid lifting.
  • Slowly increase your activities. Begin with light chores, short walks, and some driving. Depending on your job, you may be able to return to work.
  • To promote healing, eat a diet rich in fruits and vegetables.
  • Try to avoid constipation by:
    • Eating high-fiber foods
    • Drinking plenty of water
    • Using stool softeners if needed

Exploratory laparotomy – Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Fever or chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Increasing pain or pain that does not go away
  • Your abdomen becomes swollen or hard to the touch
  • Diarrhea or constipation that lasts more than 3 days
  • Bright red or dark black stools
  • Dizziness or fainting
  • Nausea and vomiting
  • Cough, shortness of breath, or chest pain
  • Pain or difficulty with urination
  • Swelling, redness, or pain in your leg
  • In case of an emergency, call for medical help right away.

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