A laparotomy is a surgical procedure where an incision is made in the abdomen, either diagnostically or therapeutically, and is typically performed by a general surgeon. It can be used to look for the cause of a medical problem, treat problems such as gunshot wounds and bleeding, or access the abdomen for a medical procedure. Recovery time can be extended due to the large incision.
A laparotomy is literally an ‘incision in the abdomen’, usually across the flank. This surgical procedure can be performed diagnostically or therapeutically, depending on the patient’s situation, and is typically performed by a general surgeon. When laparotomies are performed, the patient is given general anesthesia, as the procedure is quite invasive and the patient would be extremely comfortable if they were awake.
In a diagnostic laparotomy, also known as an exploratory laparotomy or ex-lap, the surgeon opens up the patient to see what’s going on inside the body. This type of exploratory surgery can be used to look for the cause of a medical problem, to learn more about abnormalities seen on medical imaging studies, and to treat problems such as gunshot wounds and bleeding, where the abdomen needs to be opened to see the source of the problem and fix it. In some cases, the general surgeon may work with a specialist such as an oncologist so that abnormalities seen during the laparotomy can be addressed promptly.
In a therapeutic laparotomy, the incision is made to access the abdomen for a medical procedure. In some cases, it may be possible to perform a laparoscopic procedure, in which instruments are inserted through small incisions in the skin and the inside of the abdomen is viewed with a camera. This option is much less invasive, but can be limiting for the surgeon, and there may be situations where a laparoscopy is scheduled, but a surgeon ends up needing to perform a laparotomy to see more clearly or to remove diseased tissue.
Before a laparotomy, the patient will be interviewed and tests will be performed to confirm that they are a good candidate for surgery. The surgeon will meet with the patient to discuss the reason for the procedure and any potential complications that may arise, and the patient will also meet with the anesthetist who will administer anesthesia. After the procedure is complete, the patient will be taken to a recovery area and monitored.
Recovery time from a laparotomy can be extended because the incision can be quite large. Pain management is very important, especially in the first few days, and the patient may be asked to rest to avoid straining the incision. Temporary changes to the patient’s diet are usually made and he or she is monitored closely for signs of infection and other complications.
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