Laparotomy, Exploratory

What is an exploratory laparotomy?

An exploratory laparotomy is a surgery that allows your healthcare provider to look more closely at organs and tissues in your belly or pelvis (the area below your belly and between your hips). These organs include the liver, intestines, gallbladder, appendix and, in women, the uterus, ovaries, and fallopian tubes. This procedure may help your provider find and treat the cause of medical problems you may be having, such as:

• Pain, an abnormal lump, or fluid in your belly
• Appendicitis
• Liver disease
• Bowel problems
• Gallstones
• Uterine or ovarian problems

How is an exploratory laparotomy done?

Before the procedure:

• Your healthcare provider will ask you to sign a consent form for a laparotomy. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
• There is risk with every treatment or procedure. Talk to your healthcare provider for complete information about whether any of these risks apply to you:
  • Anesthesia problems
  • Bleeding
  • Blood clots
  • Infection
• Follow any instructions your provider gives you to prepare for surgery, including not eating or drinking anything.
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or recreational or illegal drugs.
• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

• You may be given a sedative through your IV to help you to relax.
• You will be given medicines to prevent pain during your surgery. These may include:
  • Regional anesthesia, which numbs a large area of your body. Depending on the medicine, you may be awake or asleep during the procedure.
  • General anesthesia, which relaxes your muscles and puts you into a deep sleep. It also keeps you from remembering the operation. While you are asleep, you will have a tube in your throat to help you breath and to make sure you are getting enough oxygen. The tube may be removed before you wake up after the surgery.
• You may have a small tube (catheter) placed into your bladder to drain and measure urine.
• Your surgeon will make a cut in your belly. The size of the cut will depend on what your doctor needs to see and possibly treat.
• Your provider will be able to treat any abnormal conditions he or she sees, including:
  • Removing an infected or inflamed appendix or other part of the bowel
  • Removing a gallbladder with gallstones
  • Removing your uterus or ovaries
  • Removing a tumor. If an abnormal growth is found, your provider may take a sample of the growth to send to the lab for testing. Or the entire growth may be removed
  • Draining fluid from your belly. If you have an infection, a temporary may be left in your surgery site to drain blood and fluid for a few days after surgery.

After the procedure:

• You will be checked often by nursing staff.
• Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
• Your heart rate, blood pressure, and temperature will be checked regularly.
• Your sutures and dressing will be checked regularly.
• If you have a drainage tube, your dressings will be changed often.
• For the first day or so after surgery, you may not be given anything to eat or drink. Then you will be allowed to have small amounts of water. If you can drink water without vomiting, you can have clear liquids and then some solid food until you are able to have your normal diet.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat or prevent side effects, such as nausea or constipation, from other treatments
  • Soften and reduce straining with a bowel movement
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Dizziness
  • Fainting
  • Nausea or vomiting
  • Shortness of breath
  • Bloating or belly pain
  • Swelling, redness, or pain in your legs
  • Change in bowel habits, such as pain, mucus, diarrhea, constipation, or other intestinal problems
  • Redness, swelling, pain, warmth, or drainage from your surgical wound
  • Fever, chills, or muscle aches
• Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many things, such as your general health, why you are in the hospital, and the treatment you need. This is often 5 to 10 days after you have the procedure. Talk with your provider about how long your stay may be.