A laparotomy is a surgery of the abdomen. There are two types of laparotomy: open and endoscopic (laparoscopic).
The open procedure requires a standard surgical incision.
Endoscopic exploration, laparoscopy, is done through small, key hole incisions that allow passage of thin instruments that both see inside the abdomen and are able to manipulate organs. Several surgeries that previously required long open incisions, like
gallbladder removal
and
tubal ligation
, can now be done using this technique.
A laparotomy is performed on the abdomen.
A laparotomy is a diagnostic procedure used to assess disease in the abdomen. One of the more frequent reasons for a laparotomy is to determine the extent a cancer has spread. It is also used for acute situations in which the cause of the problem is unknown but the location is within the abdomen. Examples include perforated bowel,
ectopic (outside the womb) pregnancy
,
endometriosis
,
appendicitis
, bleeding, and inflammation of the pancreas. If the diagnosis made at laparotomy is amenable to further surgery, it is often done immediately.
Your general health and the underlying disease that has prompted the laparotomy will determine your risk. A laparotomy by itself poses minimum risk.
An exploratory laparotomy is the last choice diagnostic procedure. It has become far less common now that
ultrasound
,
CT
,
MRI
, and a wider range of catheter-guided, contrast-enhanced x-ray procedures are available. You will have had a thorough evaluation before proceeding to laparotomy unless there is an urgent, life-threatening need to proceed to laparotomy without testing.
General anesthesia is almost always used. Local or spinal anesthesia can be used, particularly in patients who are very ill.
After you are put to sleep and your abdomen is scrubbed, the surgeon will make either one long incision (open procedure) or several small ones (laparoscopy). During an open procedure, every one of your abdominal organs will be carefully examined for disease.
During laparoscopy, critical and suspicious organs will be explored, using instruments passed through other small incisions to grasp and move structures out of the way to see around them. Usually a television will be used to project images from the endoscope. The surgeon may take samples (
biopsies
) from suspicious areas and send them to the pathology laboratory for study.
If another procedure appears to be indicated, the surgeon may well go ahead and repair the problems discovered.
Recovery from open laparotomy will require several days in the hospital. Recovery from laparoscopic procedures frequently will only take several hours.
Exploratory laparotomy may take anywhere from 1 to 4 hours or more, depending upon how difficult it is to make the diagnosis.
There will be the usual amount of postoperative pain but you will receive pain medication to relieve this discomfort.
If you require a spinal or local anesthesia, there may be pain during the procedure for which the anesthesiologist will medicate you.
Bleeding, infection, and drug reactions are the most common side effects of surgery. If no further surgery is performed following the laparotomy, the risks are minimal and based on the underlying disease.
A laparotomy will extend your hospital stay by several days, but you will already have been through an extensive evaluation and may need additional hospitalization to treat the problems discovered.
A laparotomy by itself will require observation for complications, several days to recover, and suture or staple removal a week to ten days later.
Your outcome will depend entirely on the nature of the problem that brought you to surgery.
- Bleeding or discharge from the incisions
- Fever
- Increasing or unremitting pain
- Nausea or vomiting
- Constipation
beyond the first few days
- Pain or swelling in your legs
- Cough
or difficulty breathing
- Pain or difficulty with urination
Last reviewed November 2007 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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