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What Is a Laparotomy?

A patient is usually given general anesthesia before a laparotomy.
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  • Written By: Mary McMahon
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  • Last Modified Date: 11 November 2014
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A laparotomy is literally an “incision in the abdomen,” usually through the flank. This surgical procedure can be performed diagnostically or therapeutically, depending on a patient's situation, and it is typically done by a general surgeon. When laparotomies are performed, the patient is given general anesthesia, as the procedure is quite invasive, and the patient would be extremely comfortable if he or she was awake.

In a diagnostic laparotomy, also known as an exploratory laparotomy or ex-lap, the surgeon opens the patient up to see what is going on inside the body. This type of exploratory surgery can be used to look for a cause for a medical problem, to learn more about abnormalities seen in medical imaging studies, and for treatment of issues like gunshot wounds and hemorrhage, in which the abdomen needs to be opened up to see the source of the problem and correct it. In some cases, the general surgeon may work with a specialist such as an oncologist so that abnormalities seen in the course of the laparotomy can be addressed promptly.

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In a therapeutic laparotomy, the incision is made to gain access to the abdomen for the purpose of a medical procedure. In some cases, it may be possible to perform a laparoscopic procedure, in which instruments are inserted through small incisions in the skin and the inside of the abdomen is viewed with a camera. This option is much less invasive, but it can be limiting for the surgeon, and there may be situations in which a laparoscopy is scheduled, but a surgeon ends up needing to perform a laparotomy to see more clearly or to remove diseased tissue.

Prior to a laparotomy, the patient will be interviewed and tests will be run to confirm that he or she is a good candidate for surgery. The surgeon will meet with the patient to talk about the reason for the procedure and potential complications which may emerge, and the patient also meets with the anesthesiologist who will be administering the anesthesia. After the procedure is over, the patient will be taken into a recovery area and monitored.

The recovery time from a laparotomy can be extensive, because the incision may be quite large. Pain management is very important, especially in the early days, and the patient may be required to rest to avoid straining the incision. Commonly temporary adjustments to the patient's diet are made, and he or she is monitored closely for signs of infection and other complications.

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bagley79
Post 6

If I had the choice between a laparotomy vs a laparoscopy, I would go with the laparoscopy every time.

I have had both types of surgeries, and can say the recovery time for a laparoscopy is so much shorter and less painful.

For my last surgery, they were hoping they could do this laparoscopically, but my problem was worse than they thought and they ended up doing a laparotomy.

I was really disappointed when I woke up because I knew how much longer it was going to take me to get back to normal. I was glad to be over the constant pain, but was hoping I wouldn't have to miss as much work.

andee
Post 5

Having any type of exploratory surgery is unsettling because you don't know what they might find.

I had a laparotomy cholecystectomy to remove my gallbladder. At the time, they didn't know for sure what my problem was.

They thought it might be my gallbladder, but all the tests came back inconclusive. The pain continued, so they decided to to an explatory laparotomy.

Using a laproscope would have been much less invasive, but they wanted to be sure and not take any chances. This was also done many years ago, when they didn't do as many laparoscopic surgeries like they do today.

myharley
Post 4

@ysmina - I had a situation similar to yours. I was having abdominal pain for many years, and they always thought it was related to female issues.

One day the pain was intense and would not go away. I was scheduled for exploratory surgery because they really didn't know what to expect.

My gynecologist was working with the general surgeon because they still thought this was a female problem.

Come to find out, my appendix had ruptured, and that is what was causing all the pain. After the laparotomy they said I might go down in the history books. The surgeon said my pain all these years was probably from my appendix leaking then sealing itself back up.

It also took me a long time to recover from that procedure. I was in the hospital for at least a week taking antibiotics. Once I got home, it was slow going for a long time and I couldn't even drive for at least 2 weeks.

ysmina
Post 3

@fify-- I guess everyone is different! I had an emergency laparotomy three years ago because of appendicitis and it took me a really long time to get back to doing stuff! It was like ten weeks! And I still couldn't do too much for several weeks after that. I was sore for several months.

The surgery itself went really well. I was actually more scared about getting anesthesia than I was about the actual surgery. I was also worried about the pain I would be in after the surgery. But I managed through it with pain relievers. I was also on antibiotics for a little while to prevent any infections.

The biggest challenge is probably having someone with you during recovery so that they can help you, cook, run errands, etc. I was lucky to have my sister with me.

fify
Post 2

@feruze-- The recovery time depends on why you are having the laparotomy. I had a laparotomy during a hysterectomy. My doctor had told me before the surgery that it would take about 6 weeks to recover. However, I felt much better and could walk around and do some light chores at week 5.

I have a distant relative who had the same operation, but it took her 8 months of recovery plus several weeks of rehabilitation. So your doctor is right, it's kind of hard to know how long it might be. It depends on how fast your body will deal with it.

I do think that you should give yourself a good 6 weeks though. And you might not want to give a specific time frame to your boss and just update them later. Good luck!

bear78
Post 1

So how long is the recovery time for a laparotomy then? I understand it takes a while, but is it like 4 weeks, 5 weeks?

I'm due for a laparotomy next month and have no idea what to expect in terms of recovery. My doctor won't tell me how long, she says she has to see how I progress. But I really need to know as I have a lot of responsibilities at work. I don't want to tell my boss that I'll be out for four weeks and then have it take longer.

Has anyone had a laparotomy? Can you tell me how long it took for you to get back to work, chores, etc? Did you have to get any rehabilitation or anything?

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