A laparotomy is a surgical procedure for examining the inside of the abdomen and other internal organs and to look for abnormalities. The most common reason for performing this procedure is for the removal of the uterus, ovaries, fibroid, or fallopian tubes. You need to have a complete understanding of the procedure before you go through with it.

The most common reason to get a laparotomy is to investigate the reason behind the abdominal pain but it can be used for a broad range of indications. The abdominal organs include the organs in the digestive tract (stomach, intestines, and liver) and the excretion organs (kidney and bladder). To find the exact cause of the pain, your doctor may have to operate.

Before you go for the operation, you must make sure that your doctor knows about your surgical and medical history and any other lifestyle factor that might affect the operation. This includes smoking history and current medications. Discuss with your doctor to understand the possibility of another surgery once the diagnosis is done. Your doctor will also inform you about the pre-operative procedures and what to expect after the operation.

At the Apollo Cradle Motinagar, we believe in providing the best care and treatment to our patients. With our infrastructure, technology, and dedicated team of doctors, nurses, and technicians, we can help you deal with any condition you might have.

Who might need a laparotomy?

The procedure might be needed to treat a particular condition or look for issues in the abdomen or the internal organs.

  1.    Check the spread of diseases like cancer and endometriosis
  2.    Injury to the abdomen
  3.    Abdominal pain

The laparotomy will leave behind a large incision in the abdomen. So make sure that you understand why you need a laparotomy.

Immediately before the operation

Before the operation, here is what would be done:

  •    Make sure that you have done all the tests that the doctor asked you to do.
  •  You need to stop taking any blood thinning or arthritis medication. Check with your doctor which medications you can or cannot take.
  •  Do not eat or drink anything at least 6 hours before the operation. This includes water, lollies or chewing gum. If you have a morning procedure, stop eating after 12 am and if you have an afternoon procedure, stop at 6 am.
  •    Do not use any skin products after the shower like body lotion, powder, perfume, deodorant, etc.)
  •  Bring the reports of all your blood, ECG tests, X-rays, any medications that you might have to take, sanitary pads, toiletries, etc.

Once you reach the hospital, here is what will go down:

  1.    Your abdominal area will be shaved.
  2.    You will have to take a bath using a surgical scrub lotion and you will have to wear a theatre gown.
  3.    To help you empty your bowels, you will be given enema or some other form of bowel preparation.
  4.    A note about your allergies will be made.
  5.    You will have to fast for a number of hours before the procedure.

Laparotomy procedure

Here is how the laparotomy procedure is performed:

  1.    You will be given general anesthesia using an IV needle.
  2.    A single, large cut will be made through the skin and muscle of the abdomen. This will give the surgeon a proper view of the underlying organs.
  3.    Then, there will be a careful examination of the exposed organs.
  4.    After the diagnosis is completed, if possible, the condition will be treated on the spot. In some cases, a second operation might be needed.
  5.    After the laparotomy is performed, the overlying skin and the muscle of the abdominal wall will be sutured shut.

Immediately after the operation

After the operation, this is what you can expect:

  1.    For a few hours, your pulse, temperature, blood pressure, respiration, and the wound site will be carefully monitored.
  2.    There might be a drain inserted at your wound site.
  3.   To help you drain stomach secretions, a small tube will be passed into your stomach through your nose for a day or two. This will give your digestive tract some time to heal.
  4.    To drain off urine, a urinary catheter might be inserted.
  5.   You won’t be allowed to eat for a few days, so you will be given intravenous fluids directly through the veins.
  6. You will be regularly given pain relief to keep you comfortable.
  7.   You will be asked to do some leg exercises and deep breathing.
  8.   You will be assisted out of the bed after the procedure. Some early walking is recommended as it reduces the risk of chest infections and blood clots.
  9.    You will be given advice on how to care for your wound at home.

Taking care of yourself at home

Here is how you need to take care of yourself at home after the procedure:

  •    Rest for at least 2 weeks.
  •    Ask your friends and relatives to help you around the house.
  •    Do not try any pulling, pushing or heavy lifting.
  •    You will be given a modified diet after you are discharged from the hospital. Make sure that you follow all the dietary suggestions.
  •    Follow all the instructions precisely and don’t forget to take your medications.
  •    Do all the exercises that were shown in the hospital.
  •    If your wound becomes tender, inflamed, or starts to discharge, consult your doctor immediately. This may be a sign of infection.

Recovery

A laparotomy is a major operation and it can take up to months for you to resume back to your normal day-to-day activities. It totally depends on the underlying cause of your illness. During the recovery period, you will get tired easily and feel a general lack of energy. Regular, gentle exercises are recommended during this period. Take extra care while lifting heavy objects. For at least 4 to 6 weeks, there should be no heavy lifting. Then, slowly build up towards your normal level of physical activity. At this stage, you should be able to resume sexual activity. During the course of the recovery period, you will be feeling a range of emotions ranging from fear and frustration to anger and despair.

The first part of the recovery process is wound care. It is common to see blood on your wound dressing. You might also see some swelling and bruising around the incision. Ask your doctor if you can wet the wound or not. If stitches or staples were used to shut the wound, you should keep the wound dry for at least 48 hours. After that, when you shower, use warm water and unscented soap. Use a towel to pat yourself dry. If non-dissolvable sutures were used for closing the wound, you will get them removed about 10 to 15 days after the procedure. As the wound starts to heal, you will start getting some odd sensations. You will feel an itch, tingle or the wound just feel numb for some time. This will improve over the course of a few months.