Exploratory Laparotomy

An exploratory laparotomy is a surgical procedure that allows the examination of your abdominal organs. Your surgeon will make one incision, cutting through the abdominal skin and muscle to reveal your organs. This can help your medical team diagnose and treat various abdominal and digestive conditions.

If imaging tests such as X-rays and CT scans have not provided an accurate diagnosis, your doctor may recommend a laparotomy. Exploratory laparotomy procedure may be used to help diagnose and treat many health conditions, including:

Cancer of the liver, ovary, colon, pancreas
Gallstones
Acute appendicitis
Diverticulitis
Endometriosis
Hole in the intestine (intestinal perforation)
Chronic pancreatitis
Liver abscess
Pregnancy outside of the uterus (ectopic pregnancy)
Adhesions in abdomen.

Procedure

Before the Procedure

A surgeon does the surgery and takes place in a hospital. Do the following to prepare for surgery:

Inform your doctor about any medications that you're taking. This includes over-the-counter, prescription, and herbal medications, as well as vitamins and other supplements. You may need to discontinue them prior to surgery.
Tell your doctor if you drink alcohol. If you are a heavy drinker, this is critical as alcohol withdrawal can be life-threatening.
Inform your doctor if you have a history of any allergies or other health issues. This includes recent illnesses, particularly any bleeding disorders.
Stop smoking. Don't smoke on the day of surgery.
You may be recommended to fast 8 hours the night before the surgery.

During the Procedure

Many exploratory laparotomy surgical procedures are performed as an emergency response to an injury or accident.
During surgery, you will be evaluated for the possibility of heart, lung, or other problems.
You must put on a hospital gown.
An IV (intravenous) line is inserted into a vein in your arm or hand prior to surgery. This line provides fluids and medications.
During the procedure, you will be given pain medication (general anesthesia) which puts you in deep sleep.
During the surgery, a breathing tube may be placed through your mouth into your throat to assist with breathing. In addition, monitors are attached to your body. During surgery, these assess your vital signs, such as oxygen levels, heart rate, and blood pressure.
During the surgery, a thin catheter tube is inserted into your bladder to drain urine.
The skin over your belly is cleaned and an incision is made.
The tissue, blood vessels, structures and organs in your belly are examined and checked for problems.
Biopsy is done by removing tissue samples and sent to a lab for study.
If the cause of the problem is detected, treatment may be done immediately, if needed.
After surgery, the incision is closed with stitches or staples. To remove any excess fluids, an abdominal drain may be placed.

After the Procedure

You will be transferred to the post-anesthesia care unit (PACU), where you will be monitored closely until you have recovered from the anesthesia. You will be shifted to your hospital room once you are more awake, alert, and stable.
Medicines are given to manage pain and prevent infection.
You may not be given food until your bowels resume normal function. This could take several days.
You must get up and walk around with assistance as soon as possible. This aids in the prevention of blood clots.
You may be encouraged to cough and do deep breathing exercises. These are helpful for preventing pneumonia.
The urine drain tube may be left in place for a few days or removed following surgery.
If a drain was used, it is usually removed prior to discharge. If not, you will be shown how to maintain and empty the drain at home.
When the surgeon says there are no issues to be concerned about, you will be able to go home.
Arrange for an adult family member to drive you home.
Make sure you have all of the prescriptions and home care instructions you'll need before you leave. Make sure you have the phone number of your surgeon or the hospital as well. This is in case you have any problems or questions following the surgery.
Avoid constipation, especially if you are taking opioid pain medications. Take a fibre diet as directed and follow bowel care instructions provided by your surgeon.
Don't lift anything heavier than 2kg for about six weeks. This gives tissues time to heal and can prevent a hernia.

Benefits

Exploratory laparotomy is a surgical procedure that can provide several benefits, depending on the specific condition and circumstances. Some potential benefits of exploratory laparotomy include:

Diagnosis

Exploratory laparotomy allows the surgeon to directly visualize and inspect the abdominal organs and structures, which can aid in diagnosing the cause of abdominal pain or other symptoms that may be unclear from imaging studies alone. It can help identify conditions such as tumors, infections, adhesions, or injuries to the abdominal organs.

Treatment

In addition to diagnosis, exploratory laparotomy can also be therapeutic. Once an issue has been identified, the surgeon can perform necessary surgical interventions during the same procedure. This can include the removal of tumors, repair of injured organs, resection of diseased bowel, or treatment of other conditions found during the surgery.

Flexibility

Exploratory laparotomy provides the surgeon with direct access to the abdominal cavity, allowing for a thorough examination and intervention as needed. It provides flexibility to address unexpected findings that may not have been visible in imaging studies or detected during less invasive procedures.

Comprehensive evaluation

Exploratory laparotomy allows the surgeon to evaluate the entire abdominal cavity, including all the organs and structures within it. This can help identify multiple issues or conditions that may be contributing to the symptoms and health concerns of patients.

Emergency Situations

In emergency situations, such as trauma or acute abdominal emergencies, exploratory laparotomy can be a life-saving procedure. It allows for rapid access to the abdominal cavity to identify and address the source of the emergency, such as controlling bleeding, repairing injuries, or removing obstructions.

Risks

Risks and complications can vary depending on the reason for the surgery. The most common risks and potential complications are as follows:

Bleeding
If the cause of the problem cannot be identified, additional surgery or other treatments may be required.
Incision doesn't heal
Damage, injury, or problems with the bowels
Risks of reaction to anesthesia
Hernia at the incision site
Need for additional surgeries
Scarring
Infection