Exploratory surgery; Laparotomy; Exploratory laparotomy
Abdominal exploration is surgery to look at the organs and structures in your belly area (abdomen). This includes your:
- Appendix
- Bladder
- Gallbladder
- Intestines
- Kidney and ureters
- Liver
- Pancreas
- Spleen
- Stomach
- Uterus, fallopian tubes, and ovaries (in women)
Surgery that opens the abdomen is called a laparotomy.
Description
Exploratory laparotomy is done while you are under general anesthesia. This means you are asleep and feel no pain.
The surgeon makes a cut into the abdomen and examines the abdominal organs. The size and location of the surgical cut depend on the specific health concern.
A biopsy can be taken during the procedure.
Laparoscopy describes a group of procedures that are performed with a tiny camera placed inside the abdomen. If possible, laparoscopy will be done instead of laparotomy.
Why the Procedure is Performed
Your doctor may recommend a laparotomy if imaging tests of the abdomen, such as x-rays and CT scans, have not provided an accurate diagnosis.
Exploratory laparotomy may be used to help diagnose and treat many health conditions, including:
- Cancer of the ovary, colon, pancreas, liver
- Endometriosis
- Gallstones
- Hole in the intestine (intestinal perforation)
- Inflammation of the appendix ( acute appendicitis )
- Inflammation of an intestinal pocket ( diverticulitis )
- Inflammation of the pancreas ( acute or chronic pancreatitis )
- Liver abscess
- Pockets of infection (retroperitoneal abscess, abdominal abscess, pelvic abscess)
- Pregnancy outside of the uterus ( ectopic pregnancy )
- Scar tissue in the abdomen ( adhesions )
Risks
Risks of anesthesia and surgery in general include:
- Reactions to medicines, breathing problems
- Bleeding, blood clots, infection
Risks of this surgery include:
- Incisional hernia
- Damage to organs in the abdomen
Before the Procedure
You will visit with your health care provider and undergo medical tests before your surgery. Your provider will:
- Do a complete physical exam.
- Make sure other medical conditions you may have, such as diabetes, high blood pressure , or heart or lung problems are under control.
- Perform tests to make sure that you will be able to tolerate the surgery.
- If you are a smoker, you should stop smoking several weeks before your surgery. Ask your provider for help.
Tell your provider:
- What medicines, vitamins, herbs, and other supplements you are taking, even ones you bought without a prescription.
- If you have been drinking a lot of alcohol, more than 1 or 2 drinks a day
- If you might be pregnant
During the week before your surgery:
- You may be asked to stop taking drugs that make it hard for your blood to clot. Some of these are aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), clopidogrel (Plavix), or ticlopidine (Ticlid).
- Ask your doctor which drugs you should still take on the day of your surgery.
- Prepare your home for your return from the hospital.
On the day of your surgery:
- Follow your provider’s instructions about when to stop eating and drinking.
- Take medicines your provider told you to take with a small sip of water.
- Arrive at the hospital on time.
Outlook (Prognosis)
You should be able to start eating and drinking normally about 2 to 3 days after the surgery. How long you stay in the hospital depends on the severity of the problem. Complete recovery usually takes about 4 weeks.
D’Souza RE, Novell R. Laparotomy: elective and emergency. In: Novell R, Baker DM, Goddard N, eds. Kirk’s General Surgical Operations . 6th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 4.
Squires RA, Postier RG. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 47.
