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Exploratory Laparotomy
Exploratory Laparotomy
What is an Exploratory Laparotomy?
This is a surgical operation performed with the objective of gathering information which is not available through usual clinical diagnostic methods. An exploratory laparotomy is used to see and examine the abdominal cavity and the organs inside it.
Where is the procedure performed and who performs it?
An exploratory laparotomy is usually performed in a hospital operating room by a general or specialized surgeon. However, the procedure may be performed by an emergency room physician if there is trauma to the abdomen.
Why perform the procedure?
- If the patient has been in blunt and/or penetrating trauma situations and life-threatening injuries are suspected.
- If the doctors need to search for a unifying cause of multiple signs and symptoms of diseases.
- If the patient is suffering from acute or unexplained pain in the abdomen.
- If the doctors need to perform staging in patients with a malignant disease.
- If there is overwhelming evidence of internal bleeding.
- If imaging tests such as CT scans and x-rays have not given an accurate diagnosis of the abdomen.
Other conditions that may be investigated or discovered during the procedure include:
- Intestinal perforation
- Pregnancy occurring outside of the uterus (ectopic pregnancy)
- Inflammation of the appendix (appendicitis)
- A localized area of infection (abscesses)
- Cancer of the abdominal organs
- Foreign bodies such as a bullet in a gunshot victim
- Inflammation of the pancreas (pancreatitis)
- Bands of scar tissue that form after trauma or surgery (adhesions)
- Inflammation of the peritoneum (peritonitis)
- Inflammation of sac-like structures, that in the walls of the intestines (diverticulitis)
How is exploratory laparotomy performed?
- The procedure will be done while you are under general anesthesia which means that you will be asleep and will feel no pain.
- Once you are under the surgeon will make an incision into the abdomen and then examine the abdominal organs. The location and size of the incision will be determined by the specific health concern. During the procedure, a biopsy may be taken.
- The exploratory may immediately lead to other surgical procedures such as; hepatic resection, splenectomy, repairs of the aorta, repairs of the vena cava, repairs of the iliac arteries or veins, pericardial window, bowel and enterotomy repair, small bowel, resection, distal pancreatectomy, right hemicolectomy, left hemicolectomy, gastric diversion, pyloric exclusion and nephrectomy.
- Following the exploratory laparotomy, the stability of the patient will determine whether the abdomen will be closed primarily or temporarily with a saline bag, vacuum dressing or towel clips. Temporary closing facilitates further nonsurgical resuscitation before definitive closure.
What should be cared?
You will remain in the hospital recovery room for several hours for close monitoring after the procedure. One to two days after the procedure you may be allowed to go home if no additional procedures need to be performed and there were no complications.
