Exploratory Laparotomy

What is Exploratory Laparotomy

Exploratory laparotomy is a surgical procedure to examine the organs inside your belly (abdomen). Another name for this is abdominal exploration. You may have this procedure if you have abdominal pain, trauma, bleeding, infection, or obstruction.

The procedure may be done if your health care provider cannot make a diagnosis from only an exam and testing.

Exploratory laparotomy may be a planned procedure or an emergency procedure. You may have surgical treatment as part of the laparotomy, or you may have additional treatment after your laparotomy. This will depend on what your surgeon finds during the procedure.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems can occur and include:

• Bleeding.
• Infection.
• A blood clot that forms in your leg and travels to your lungs.
• Damage to organs inside your abdomen.
• Scar tissue that blocks your digestive tract.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
• Do noteat or drink anything after midnight on the night before the procedure or as directed by your health care provider.
• You may be given instructions for clearing out your bowel before surgery (bowel prep). If you are already in the hospital, the bowel prep may be done there.

What happens during the procedure?

• An IV tube may be inserted into a vein. You may receive fluids and medicine through the IV tube. This may include antibiotic medicine to treat or prevent infection.
• You will be given a medicine that makes you go to sleep (general anesthetic).
• You may have a tube placed through your nose and into your stomach (nasogastric tube) to drain your stomach fluids.
• You may have a tube placed into your bladder (urinary catheter) to drain urine.
• Your abdomen will be cleaned with a germ-killing solution (antiseptic).
• The surgeon will make a surgical cut (incision) in your abdomen. This is usually an up-and-down incision in the midsection of your abdomen. The incision will go through the inside lining of your abdomen (peritoneum).
• Your surgeon will spread the incision wide enough to examine the inside of your abdomen.
• The rest of the procedure will depend on what the surgeon finds:
  • The surgeon will check all organs in your abdomen for damage or obstruction. Repairs will be made when possible.
  • If there is blood in the abdomen, the surgeon will look for the source of the bleeding in order to stop it.
  • If there is yellowish-white fluid (pus) or gastric fluids in your abdomen, the surgeon will check for an infection or a hole (perforation) in your digestive tract.
  • If the surgeon finds infection, a drain may be placed to empty fluid that can build up in your abdomen after surgery.
  • If there is a growth (tumor) inside your abdomen, the surgeon may remove a piece of the growth (biopsy) to examine it under a microscope.
• When all procedures are complete, the surgeon will close your abdomen with layers of stitches (sutures).
• The incision through the skin of your abdomen will be closed with sutures or staples.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will continue to receive fluids and nutrition through your IV tube. This will stop when you can eat and drink on your own.
• You may also get antibiotic medicine and pain medicine through your IV tube.
• Your nasogastric tube may be removed when you start to pass gas.
• Your urinary catheter may be removed when the anesthetic wears off.

Care After Exploratory Laparotomy

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After your procedure, it is typical to have:

• Abdominal soreness.
• Fatigue.
• A sore throat from tubes in your throat.
• A lack of appetite.

Follow these instructions at home:

Medicines

• Take medicines only as directed by your health care provider.
• Do notdrive or operate heavy machinery while taking pain medicine.

Incision care

• There are many different ways to close and cover an incision, including stitches (sutures), skin glue, and adhesive strips. Follow your health care provider’s instructions about:
  • Incision care.
  • Bandage (dressing) changes and removal.
  • Incision closure removal.
• Do nottake showers or baths until your health care provider says that you can.
• Check your incision area daily for signs of infection. Watch for:
  • Redness.
  • Tenderness.
  • Swelling.
  • Drainage.

Activity

• Do notlift anything that is heavier than 10 pounds (4.5 kg) until your health care provider says that it is safe.
• Try to walk a little bit each day if your health care provider says that it is okay.
• Ask your health care provider when you can start to do your usual activities again, such as driving, going back to work, and having sex.

Eating and drinking

• You may eat what you usually eat. Include lots of whole grains, fruits, and vegetables in your diet. This will help to prevent constipation.
• Drink enough fluid to keep your urine clear or pale yellow.

General instructions

• Keep all follow-up visits as directed by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• You have chills.
• Your pain medicine is not helping.
• You have constipation or diarrhea.
• You have nausea or vomiting.
• You have drainage, redness, swelling, or pain at your incision site.

Get help right away if:

• Your pain is getting worse.
• It has been more than 3 days since you been able to have a bowel movement.
• You have ongoing (persistent) vomiting.
• The edges of your incision open up.
• You have warmth, tenderness, and swelling in your calf.
• You have trouble breathing.
• You have chest pain.