• Exploratory Laparotomy

    (Abdominal Exploration; Laparotomy, Exploratory)

    Definition

    This is an open surgery of the abdomen to view the organs and tissue inside.
    Abdominal Organs, Anterior View
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    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:

    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.

    What to Expect

    Prior to Procedure

    Leading up to your procedure:
      Your doctor may perform the following: 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.

    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

    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.

    How Long Will It Take?

    About 1-4 hours

    How Much Will It Hurt?

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

    Average Hospital Stay

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

    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

    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.

    RESOURCES

    American Cancer Society http://www.cancer.org/

    National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/

    CANADIAN RESOURCES

    Canadian Digestive Health Foundation http://www.cdhf.ca/

    Health Canada http://www.hc-sc.gc.ca/

    References

    Carson-DeWitt R. Spinal and epidural anesthesia. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated July 2009. Accessed August 8, 2009.

    Laparoscopic surgery. Women's Surgery Group website. Available at: http://www.womenssurgerygroup.com/treatments/laparoscopic.asp . Accessed August 8, 2009.

    Testing biopsy and cytology specimens for cancer. American Cancer Society website. Available at: http://www.cancer.org/docroot/ped/content/ped%5F2%5F3x%5Ftesting%5Fbiopsy%5Fand%5Fcytology%5Fspecimens%5Ffor%5Fcancer.asp?sitearea=ped . Updated December 2007. Accessed June 5, 2008.

    Revision Information

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