Exploratory laparotomy is a surgery to open up the abdomen. This surgery is performed to find the cause of problems (like belly pain or bleeding) that testing could not detect. It is also used when an abdominal injury needs emergency medical attention. This surgery procedure uses one large cut (incision). The Doctor can then see and check the organs inside the abdomen. If the cause of the problem is found during the process, then treatment is usually done at the same time. In certain cases, a minimally invasive surgical treatment called exploratory laparoscopy may be used instead. That procedure uses a tiny camera and several small incisions. But in most cases, an exploratory laparotomy is preferred.
Reasons for the Exploratory laparotomy surgery
Organs that may be examined during exploratory laparotomy include:
- Small intestine (small bowel)
- Large intestine (colon or large bowel)
- Ovaries, fallopian tubes, and uterus (in women)
- Lymph nodes
- Abdominal blood vessels
- Membranes that line the belly cavity
Getting ready for the Exploratory laparotomy surgery
The surgical operation takes place in a hospital. It is performed by a surgeon. You will likely stay in the hospital for a few days or more. To get ready for the surgery, do the following:
- Inform your Doctor about any medications you’re taking. This includes over-the-counter medicines, prescription medicines, herbs, street drugs, vitamins, and other supplements. You may need to stop taking some or all of them for a time prior to the surgery.
- Tell your Doctor if you drink alcohol. This is very necessary if you are a heavy drinker. Alcohol withdrawal can be life-threatening, so be truthful with your Doctor.
- Also inform your Doctor if you have any allergies or other health issues. This includes recent illnesses, particularly any bleeding problems.
- Follow any instructions you are given for not eating or drinking before the surgery.
Day of the Exploratory laparotomy surgery
- Most exploratory laparotomies are performed as emergency surgery after an injury or accident.
- You will be examined for risks of heart, lung, or other problems during surgery.
- You may need to put on a hospital gown.
- Before the surgical operation starts, an IV (intravenous) line is put into a vein in your arm or hand. This line supplies fluids and medicines.
- You will be given a medication (general anesthesia) to keep you free of pain. This medicine puts you in a deep sleep during the surgery.
- A tube may be placed through your mouth and into your throat to aid breathing. Also, video monitors are attached to your body. These record your vital signs, such as heart rate and blood pressure, throughout the surgery.
- A thin tube (catheter) is placed into your bladder. This tube drains urine from your bladder throughout the surgery.
During the Exploratory laparotomy surgery
- The skin over your belly is cleaned.
- An incision is made on your stomach.
- The tissue, blood vessels, and organs in your belly are carefully examined for problems.
- Tissue samples (biopsy) may be removed and sent to a lab for study.
- If the cause of the problem is detected, treatment may be done then, if necessary.
- When the surgery is done, the incision is closed with stitches (sutures) or staples. A drain may be placed in the abdomen to get rid of any more fluids.
After the surgery
- You will be taken to a room to rest until you have recovered from the anesthesia. Nurses will carefully monitor your condition. When you are conscious and alert, you will be taken to another room.
- Medicines are given to help avoid infection and to manage pain, if necessary.
- You will not be given food or drink until your bowels start to work well again. This may take a few days.
- You will need to get up and walk around as soon as you can. This helps to avert blood clots.
- Also, you may be given breathing exercises to do. These help prevent pneumonia.
- The tube to drain urine is normally detached within a few days.
- If a drain was used for your cut, this is also removed.
- You will be able to go home when the Doctor says there are no issues of concern.
- Arrange for an adult family member or friend to take you home.
- Before leaving, be sure you have all the medicines and home care instructions you will need. Also make sure you have a contact number for your Doctor or the hospital. This is in case you have issues or questions after the surgery.
- Do not pick up anything heavier than 5 pounds for about 6 weeks. This gives tissue time to heal, and to avoid hernia.
Recovery time varies for each person. It may take as long as four to six weeks. You will need to see your Doctor for follow-up. This is to take out any sutures or staples and to check your healing progress.
Risks and possible complications from Exploratory laparotomy surgery
These vary depending on the purpose for the surgery. The most common risks and possible complications include:
- Can't find the cause of the problem, so more surgical operation or other treatments may be needed.
- Incision doesn't heal well.
- Damage, injury, or issues with the bowels.
- Risks of anesthesia.
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