Exploratory laparotomy

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Alternative names
Laparotomy; Abdominal exploration

Definition

Abdominal exploration is a surgical procedure that opens the abdomen (laparotomy) and explores it for problems. During a laparotomy, treatment of problems may also be administered.

Description

The abdomen contains many vital organs:

• Stomach
  
• Small intestine (jejunum and ileum)
  
• Large intestine (colon)
  
• Liver
  
• Spleen
  
• Gallbladder
  
• Pancreas
  
• Uterus, fallopian tubes, and ovaries (in women)
  
• Kidneys, ureters, and bladder

Some problems inside the abdomen can be easily diagnosed with noninvasive tests such as x-rays and CT scans, but many problems require surgery to explore the abdomen to obtain an accurate diagnosis.

While the patient is under general anesthesia, the surgeon makes an incision into the abdomen and examines the abdominal organs. The size and location of the incision depends on the clinical situation. Tissue samples (biopsies) can be taken and diseased areas can be treated.

When the procedure is complete, the incision is closed.

Indications

Exploratory laparotomy may be recommended for diagnosis when there is abdominal disease from an unknown cause.

Diseases that may be discovered by exploratory laparotomy include the following:

• Inflammation of the appendix (acute appendicitis)
  
• Inflammation of the pancreas (acute or chronic pancreatitis)
  
• Pockets of infection (retroperitoneal abscess, abdominal abscess, pelvic abscess)
  
• Presence of uterine tissue (endometrium) in the abdomen (endometriosis)
  
• Inflammation of the fallopian tubes (salpingitis)
  
• Scar tissue in the abdomen (adhesions)
  
• Cancer (of the ovary, colon, pancreas, liver)
  
• Inflammation of an intestinal pocket (diverticulitis)
  
• Hole in the intestine (intestinal perforation)
  
• Pregnancy outside of the uterus (ectopic pregnancy)

This surgery may also be used to determine the extent of certain cancers, such as Hodgkin’s lymphoma.

Risks
Risks for any anesthesia include the following:

• Reactions to medications
  
• Problems breathing

  Risks for any surgery include the following:
  

  
  
  • Bleeding
    
  • Infection
  
  Additional risks include incisional hernia.

  Expectations after surgery
  The outcome from the surgery depends upon the findings.

  Convalescence
  Eating and drinking normally can usually resume 2 - 3 days after the surgery. Hospital stays vary with the severity of the underlying problem. Complete recovery usually takes about 4 weeks.

  
  
  
  Last revised: December 7, 2007
  by Mamikon Bozoyan, M.D.
  
  

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