Exploratory Laparotomy

WHAT YOU SHOULD KNOW:

An exploratory laparotomy (lap-ah-ROT-oh-mee) is surgery to look at the organs inside your abdomen. Examples of these organs are the stomach, small and large intestines, liver and uterus (in women). Caregivers may do an exploratory laparotomy to look for causes of pain. They may look for infection, disease, or torn areas in the organs. They may look for adhesions or scar tissue on the organs. An exploratory laparotomy may help caregivers to diagnose your medical problem, or take a tissue sample. Sometimes caregivers will fix the problem in your abdomen during the laparotomy.

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:

• There are always risks with surgery. You could bleed too much and have breathing problems. You may have an allergic reaction to a medicine that caregivers give to you. You may get an infection. Your intestines may slow down after surgery, causing bloating and discomfort. Caregivers will watch you closely and treat these problems. Organs such as the liver, lungs, and spleen could be damaged during surgery.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening. Later, adhesions (scar tissue) may grow where the surgery was done. You may also get an incisional hernia (weak area around the incision). Follow your caregiver's instructions carefully before and after your exploratory laparotomy.

WHILE YOU ARE HERE:

Informed consent:

A consent form 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.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

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.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

You may also need other tests before, during, and after your surgery. If you have questions, ask your caregiver.

Pre-op care:

You may be given medicine right before surgery. This medicine may make you feel sleepy and more relaxed. You are taken on a cart to the room where your surgery will be done. Caregivers help you get comfortable on the bed. A belt may be put over your legs for safety. Caregivers may put a special blanket over you to keep you warm. You may need to wear tight elastic stockings or pneumatic (air pressure) boots to help keep blood from staying in your legs and causing blood clots. You may have one of the following:

• General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing 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 (cut) in your abdomen. The size of the incision will depend on what type of problem the surgeon is looking for. The surgeon will cut through your skin and the tissue underneath it. Once the surgeon is finished with the laparotomy, he will close your abdomen. The surgeon may use sutures (stitches) to sew up the tissue underneath your skin. Then the caregivers will use sutures, staples, adhesive strips or a special surgery glue to keep the skin incision closed.

After surgery:

You are taken to the recovery room until caregivers know that you are doing OK. 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 OK. A bandage is used to cover your incision. This bandage 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 is an exercise to help decrease your risk for a lung infection after surgery. Do the following:
  
  
  • Hold a pillow tightly against your incision (cut) when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breathes help open the airways that lead to your lungs. 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 deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Hold your breath as long as you can. Let out your breath and cough. Repeat the steps 10 times every hour.
  
  
• Food and drink after surgery: You will 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 food 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.
  
  
• Foley catheter: This is a tube caregivers put into your bladder to drain your urine into a bag. Keep the bag below your waist. This will help prevent infection and other problems caused by urine flowing back into your bladder. Do not pull on the catheter, because this may cause pain and bleeding, and the catheter could come out. Keep the catheter tubing free of kinks so your urine will flow into the bag. 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.
  
  
• Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

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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.