Exploratory laparotomy is a type of abdominal surgery. It’s not used as often as it once was, but it’s still necessary in certain circumstances.
Let’s take a closer look at exploratory laparotomy and why it’s sometimes the best option for abdominal symptoms.
When you have abdominal surgery, it’s usually for a specific purpose. You may need to have your appendix removed or a hernia repaired, for example. The surgeon makes the appropriate incision and goes to work on that particular problem.
Sometimes, the cause of abdominal pain or other abdominal symptoms isn’t clear. This may occur despite thorough testing or, in an emergency situation, because there’s no time for tests. That’s when a doctor may want to perform exploratory laparotomy.
The purpose of this surgery is to explore the entire abdominal cavity to find the source of the problem. If the surgeon can identify the problem, any necessary surgical treatment can take place right away.
Exploratory laparotomy can be used when you:
- have serious or long-term abdominal symptoms that defy diagnosis.
- have had major abdominal trauma and there’s no time for other testing.
- are not a good candidate for laparoscopic surgery.
This surgery can be used to explore:
|Abdominal blood vessels||Large intestine (colon)||Pancreas|
|Fallopian tubes||Lymph nodes||Spleen|
|Gallbladder||Membranes in the abdominal cavity||Stomach|
In addition to visual inspection, the surgeon can:
- take a sample of tissue to test for cancer (biopsy).
- make any necessary surgical repairs.
- stage cancer.
The need for exploratory laparotomy is not as great as it used to be. This is due to advances in imaging technology. Also, when possible, laparoscopy is a less invasive way to explore the abdomen.
Exploratory laparotomy is major surgery. In the hospital, your heart and lungs will be checked to make sure it’s safe to use general anesthesia. An intravenous (IV) line will be inserted into your arm or hand. Your vital signs will be monitored. You may also need a breathing tube or a catheter.
During the procedure, you’ll be asleep, so you won’t feel anything.
Once your skin is disinfected, a long vertical incision will be made on your abdomen. The surgeon will then inspect your abdomen for damage or disease. If there’s suspicious tissue, a sample can be taken for biopsy. If the cause of the problem can be determined, it can be surgically treated at this time, too.
The incision will be closed with stitches or staples. You may be left with a temporary drain to let excess fluids flow out.
You’ll probably spend several days in the hospital.
After the surgery, you’ll be moved to a recovery area. There, you’ll be closely monitored until you’re fully alert. The IV will continue providing fluids. It can also be used for medicines to prevent infection and relieve pain.
After leaving the recovery area, you’ll be urged to get up and move around to help prevent blood clots. You won’t be given regular food until your bowels are functioning normally. The catheter and abdominal drain will be removed within a few days.
Your doctor will explain the surgical findings and what the next steps should be. When you’re ready to go home, you’ll be given discharge instructions that may include:
- Don’t lift more than five pounds for the first six weeks.
- Don’t shower or bathe until you get the go-ahead from your doctor. Keep the incision clean and dry.
- Be aware of signs of infection. This includes fever, or redness or yellow drainage from the incision.
Recovery time is generally around six weeks, but this varies from person to person. Your doctor will give you an idea what to expect.
Some potential complications of exploratory surgery are:
- bad reaction to anesthesia
- incision that doesn’t heal well
- injury to bowels or other organs
- incisional hernia
The cause of the problem isn’t always found during surgery. If that happens, your doctor will talk to you about what should happen next.
Contact your doctor if you experience these symptoms
Once you’re home, contact your doctor if you have:
- fever of 100.4°F (38.0°C) or higher
- increasing pain that doesn’t respond to medication
- redness, swelling, bleeding, or yellow drainage at the incision site
- abdominal swelling
- bloody or black, tarry stools
- diarrhea or constipation lasting more than two days
- pain with urination
- chest pain
- shortness of breath
- persistent cough
- nausea, vomiting
- dizziness, fainting
- leg pain or swelling
These symptoms could indicate serious complications. Call your doctor right away if you experience any of them.
Exploratory laparoscopy is a minimally invasive technique that can often be done in place of laparotomy. It’s sometimes called “keyhole” surgery.
In this procedure, a small tube called a laparoscope is inserted through the skin. A light and camera are attached to the tube. The instrument is able to send images from inside the abdomen to a screen.
This means the surgeon can explore the abdomen through a few small incisions rather than a large one. When possible, surgical procedures can be carried out at the same time.
It still requires general anesthesia. But it usually makes for a shorter hospital stay, less scarring, and faster recovery.
Exploratory laparoscopy can be used to take a tissue sample for biopsy. It’s also used do diagnose a wide range of conditions. Laparoscopy may not be possible if:
- you have a distended abdomen
- the abdominal wall appears infected
- you have many previous abdominal surgical scars
- you’ve had a laparotomy within the previous 30 days
- this is a life-threatening emergency
Exploratory laparotomy is a procedure in which the abdomen is opened up for exploratory purposes. This is done only in medical emergencies or when other diagnostic tests can’t explain symptoms.
It’s useful for diagnosing many conditions involving the abdomen and pelvis. Once the problem is found, surgical treatment can take place at the same time, potentially eliminating the need for a second surgery.