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.

Getting Ready

The week before your surgery:

• Talk to your caregiver about over-the-counter medicine such as aspirin. You may need to stop using certain medicines for a time before your laparotomy. If your caregiver has told you to take aspirin daily, do not stop without asking first.
  
  
• Tell your caregiver about any over-the-counter vitamins, herbs, food supplements, or laxatives you are using. These medicines may not work well with medicines you may need during surgery.
  
  
• You may need to have blood tests, x-rays or other tests before your surgery. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  
  
• Take any medicine that your caregiver has given you to take before surgery exactly as ordered.
  
  
• Arrange to have a family member or friend to drive you home when you leave the hospital. Do not drive yourself home.
  
  
• Your caregiver may want you to empty and clean out your bowel before surgery. Doing this may stop your bowel from getting infected after surgery. Your caregiver may ask you to do one or more of the following things:
  
  
  • Eat high fiber foods for 1 to 2 days before surgery. Good examples of high fiber foods are fruits, vegetables, and whole-wheat cereals and breads. Drink 6 to 8 (eight-ounce) cups of healthy liquids each day, unless your caregiver tells you not to.
    
    
  • Take a special medicine called a cathartic the day before surgery. A cathartic will make you have diarrhea (loose, watery stools), but it will clean out your bowel quickly.

The night before your surgery:

• Try to get enough restful sleep the night before your surgery. You may be given a pill help you sleep.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
  
  
• Ask caregivers about directions for eating and drinking.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Ask your caregiver before taking any medicine on the day of surgery. These medicines include insulin, diabetic pills, blood pressure pills, and heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
  
• Do not wear contact lenses on the day of the procedure. You may wear glasses.
  
  
• An anesthesiologist will talk to you before your surgery. This caregiver will give you medicine to make you sleep during surgery.
  
  
• You or a close family member may be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do surgery. It also explains the problems that may happen during and after your surgery, and your choices. Be sure all your questions have been answered before you sign this form.

Treatment

What will happen:

• You may be given medicine in your IV to help you relax or make you drowsy. You will be taken on a cart to the operating room. You will get medicine called anesthesia to prevent pain or keep you completely asleep during surgery. Caregivers will clean your abdomen with a special soap before surgery to get rid any germs on your skin. Sheets are put over you to keep the surgery area clean.
  
  
• 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 will use sutures (stitches) to sew up the tissue underneath your skin. Then the caregivers will use sutures or staples to close the skin incision.

After surgery:

You will be taken to a recovery room. You will be watched closely in this room until caregivers know that you are OK. You will then be taken back to your room. Do not get out of bed until your caregiver says it is OK.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You have questions or concerns about your surgery.
  
  
• You have a fever.
  
  
• You cannot make it to your surgery appointment on time.
  
  
• The problems for which you are having surgery get worse.

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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.