Exploratory Laparotomy

WHAT YOU SHOULD KNOW:

An exploratory laparotomy is surgery to look for causes of pain, infection, disease, or scar tissue inside your abdomen. An exploratory laparotomy may help your caregiver diagnose a medical problem. If your caregiver finds a problem during exploratory laparotomy, he may fix it.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Surgery could cause bleeding, breathing problems, or an infection. Your intestines may slow down after surgery, causing bloating and discomfort. Organs such as your liver, lungs, and spleen could be damaged during surgery. You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. After surgery, scar tissue may grow where the surgery was done. You may also get a weak area around the incision called an incisional hernia.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Heart monitor:

This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

Pulse oximeter:

A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

Before surgery:

You may be given medicine before surgery to make you feel sleepy and relaxed. Caregivers may put a blanket over you to keep you warm. You may need to wear tight elastic stockings or special boots on your legs. These help improve blood flow and prevent blood clots. You may have one of the following:

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

During surgery:

Your surgeon will make an incision in your abdomen. The size of the incision will depend on what type of problem the surgeon is looking for. Once the surgeon is finished with the laparotomy, he will close your abdomen. The surgeon may use stitches to sew up the tissue underneath your skin. Then he will use sutures, staples, adhesive strips, or surgery glue to keep the incision closed.

After surgery:

You will be taken to the recovery room. When caregivers feel you are ready, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is okay. The bandage over your incision keeps the area clean and dry to prevent infection. A caregiver may remove the bandage soon after surgery to check your incision.

  • Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

Medicines:

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

  • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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