Exploratory Laparotomy

If someone is having bleeding or abdominal pain and the cause of it cannot be determined, a physician may perform an exploratory laparotomy. This procedure allows the doctor to open up the abdomen to try and find the cause of the pain or bleeding. This is an effective procedure if someone suffers trauma to the abdomen and needs treatment immediately. If the physician is able to determine the problem, he may be able to treat this condition while the patient is still open from the laparotomy.

The exploratory laparotomy consists of a large incision so that the physician can look right into the abdomen and check out the organs that are located in the abdomen. Sometimes a doctor may decide to make a number of small incisions and use a camera for a closer look.

Why Is Exploratory Laparotomy Performed?

If CT scans and x-rays do not provide the physician with the information he is seeking, he may opt for a laparotomy. Conditions that may require this procedure in order to be confirmed include:

• Gallstones
• Endometriosis
• Colon, ovarian, pancreas or liver cancer
• Diverticulitis
• Appendicitis
• Chronic or acute pancreatitis
• Abscess of the liver
• Ectopic pregnancy
• Areas of infection in the abdomen or pelvis
• Adhesions in the abdomen

How to Prepare for Exploratory Laparotomy?

Before you have an exploratory laparotomy performed, there are things you must do ahead of time in order to be prepared.

• Have a physical examination.
• Get your existing health conditions under control, such as high blood pressure, diabetes, lung problems or issues with your heart.
• Your doctor will want to perform some tests to ensure you are able to tolerate this surgery.
• You should stop smoking a few weeks before the surgery.
• Let your doctor know exactly what medications, supplements, and vitamins you take, the dosage, and how many times a day you take them.
• You should also let your doctor know if you consume more than a couple of alcoholic beverages a day.
• About a week before the procedure, you might have to refrain from taking any medications that are considered blood thinners: Motrin, Advil, aspirin, Coumadin, and any others under different names.
• Find out which medications you should still take the morning and the day of your procedure.

How Is Exploratory Laparotomy Performed?

Patients who are undergoing this type of surgery will be administered general anesthesia. This will continue to be provided throughout the entire procedure so that the patient is unconscious and the muscles of the body will be totally relaxed. The patient will not be in any pain at all and have no recollection of the surgery.

The abdominal area is cleaned topically with an antiseptic before the incision is made across the abdomen. The doctor will check each organ, the blood vessels and surrounding tissue to see if he can find any problems. If the doctor does want more information on one of the organs, he will take a biopsy. Tissues will be isolated and sent to be studied at the lab.

If the doctor is able to determine what is causing the patient’s discomfort, he may repair it at this time. When the doctor completes the surgery, the doctor uses stitches or staples to close up the abdomen. If the doctor chooses, a drain may be put into the abdomen in order to get rid of any excess fluids.

Possible Complications of Exploratory Laparotomy

If you are considering a laparotomy exploratory you should be aware of the possibility of the following complications:

• Infection
• The formation of a hernia
• A reaction to the anesthesia
• Bleeding
• Blood clots
• Oversized scars
• Organ damage

Follow-Ups

After the laparotomy exploratory, you will need to follow the doctor’s orders in order to fully recover. You probably will not be able to do very much while you are at home the first couple of weeks after the surgery. You can progress to include more and more regular activities as the doctor approves them. You will probably have a prescription for paid medications which you should take as needed. Make sure that you follow the instructions on treating your wound to avoid any possibility of infection.

If you have any of the following symptoms make sure to contact your doctor immediately:

• Chills or fever
• Pain that is increasing or is not going away
• Discharge from where the incision is located or any swelling or redness
• Swollen abdomen that feels hard
• Dark black or very red stools
• Constipation or diarrhea that has gone on for over 3 days
• Vomiting and nausea
• Pain, redness or swelling in your leg
• Difficulty urinating
• Fainting of dizziness