- Procedure Time
30-60 minutes - Anaesthesia
General - Overnight stay
2 nights - Recovery Time
6 weeks
What is Laparotomy?
Laparotomy is a type of abdominal surgery that can be done to perform any operation on the small intestine, stomach, or sometimes to make a diagnosis.
The term laparotomy refers to making an incision in the abdominal wall to gain access to the contents of the abdominal cavity. Therefore, this surgical procedure is also called exploratory laparotomy. A laparotomy is a surgical incision made into the abdominal cavity and is also called an exploration laparotomy. It is performed to examine organs and structures such as appendix, intestines, kidneys, liver, pancreas, gall bladder, bladder, uterus in the lower abdomen. It is performed under general anesthesia. As in case of intestinal obstruction, another surgical procedure can be performed at the same time if necessary.
When is Laparotomy used?
Exploratory laparotomy is recommended when it is impossible to obtain an accurate diagnosis using medical tests such as X-rays and CT scans. Laparotomy surgery is useful for diagnosing and treating the following medical problems:
Abdominal pain
Abdominal trauma
Peritonitis, which is inflammation of the inner lining of the abdomen
Abdominal infection
Scar tissue or adhesions in the abdomen
Internal bleeding
Spread of conditions such as cancer or endometriosis
Ovarian cancer
Ectopic pregnancies
Endometriosis
Gallstones
Acute appendicitis
Pancreatitis (inflammation of the pancreas)
Diverticulitis (an inflammatory condition in the gut)
Intestinal perforation
Abscess or infection
Types of Laparotomy
There are types of laparotomy according to the different incision types used. These incision types are as follows:
Midline: This incision runs through the middle of the abdomen and is the standard incision for laparotomy. In cases where surgery is needed for the upper abdomen, the incision is applied only in this region without opening the entire abdomen.
Paramedian: A paramedian incision is a vertical incision that extends to one side of the midline. This incision allows access to the kidneys and adrenal glands.
Transverse: A transverse incision is a horizontal cut. It is preferred because it causes less damage to the nerves feeding the abdominal muscle and heals quickly.
Pfannenstiel: An incision can be used to access the pelvic area, as in the case of emergency cesarean delivery.
Subcostal: A subcostal incision is a diagonal incision made on one side of the upper abdomen. This incision is usually used to access the gallbladder or liver on the right or the spleen on the left.
Roof (zigzag): When a subcostal incision is made on both sides of the body, the incisions join in the middle to create a roof incision.
Laparotomy Surgery
Before The Surgery
There are some preparation stages before going into an operation. Usually, the patient is asked not to eat or drink anything for at least 6 hours before surgery. In addition, the person who will undergo the operation should give full information to the doctor about the drugs, supplements and allergies, if any, in order to avoid any possible problems with the anesthesia. The patient's life values such as blood pressure, blood values, heart rate and fever are checked and the pre-operative preparation stage is started. Before putting on the surgical gown, the patient may be asked to take a shower with a surgical lotion and shave the hair in this area. Afterwards, an enema that empties the intestines is applied and anesthesia is given.
During The Surgery
During the operation, the person is under general anesthesia and an incision is made to cut the abdominal skin and muscle to see the organs in the abdomen. The organs are examined through this incision to diagnose any problems and the condition can be treated if diagnosed promptly. (for example, if there is an intestinal hole, it can be repaired immediately). In addition, for situations that the surgeon cannot treat immediately, the patient needs to be operated again. After the diagnosis and the completion of any possible treatment, the surgeon stitches up the incision or closes it with staples or glue.
After The Surgery
After the operation, the person is taken to the waiting room to be released from anesthesia. After fully awakening, he is taken to the normal room and monitored. During this monitoring, it is necessary to closely monitor the condition of the wound and the absence of drainage. If necessary, a tube (nasogastric tube) can be inserted from the nose into the stomach to empty the stomach for a day or two. In this process, intravenous fluids are usually fed, as patients may need to avoid eating and drinking for several days after surgery. In addition, it is natural to experience pain in the incision area and may need to take regular pain medication to relieve the discomfort. Deep breathing, leg exercises and walking are recommended the day after the operation to help reduce the risk of chest infections and blood clots.
Recovery Process After Laparotomy
Laparotomy operation can be performed for a wide variety of reasons and recovery time may vary from person to person. Many other factors are also important in a person's recovery, including the person's age and general health. However, it is possible to take some steps to speed up the healing process. Here are some steps to speed up the healing process:
Resting for a specified period of time depending on the doctor's advice
Keep moving and doing recommended exercises
Follow the recommended dietary guidelines
Taking prescribed medications regularly
Avoiding all strenuous activities, including pulling, lifting, sexual activity, and swimming for 6 weeks
Are there any alternatives to Laparotomy?
The main alternative to laparotomy is laparoscopy, a less invasive technique that allows the specialist to examine the area using a camera and lighting system. Laparoscopy is a safer procedure that offers less risk of complications or bleeding.