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Exploratory Laparotomy

Exploratory laparotomy is surgery to open the abdomen to check for the cause of problems such as abdominal pain or bleeding that cannot be detected with other tests. It is particularly useful in cases of abdominal trauma requiring immediate treatment. If the cause of the problem is found, treatment is often done at the same time. To perform the surgery, one large incision is used. This allows the doctor to view and examine the organs inside the abdomen directly. In some cases, an exploratory laparoscopy may be used with a camera and several small incisions. However, there are many instances where exploratory laparotomy is preferred. Read on to learn more about exploratory laparotomy.

Reasons for the Surgery

Outline of human figure with line in center of abdomen starting at top of abdomen, curving around belly button, and ending at bottom of abdomen.
This is an example of the kind of incision the surgeon may use to perform exploratory laparotomy.

Organs that may be looked at during exploratory laparotomy include:

  • Liver

  • Gallbladder

  • Spleen

  • Pancreas

  • Kidneys

  • Stomach

  • Small intestine (small bowel)

  • Large intestine (colon or large bowel)

  • Appendix

  • Ovaries, fallopian tubes, and uterus (in women)

  • Lymph nodes 

  • Abdominal blood vessels 

  • Abdominal mesentery and peritoneum 

Preparing for the Surgery

The surgery takes place in a hospital. It is done by a surgeon. You will likely stay in the hospital for a few days or longer. To prepare for the surgery, do the following:

  • Tell the doctor of any medications you’re taking. This includes over-the-counter medications, herbs, and other supplements. You may need to stop taking some or all of them for a time before the surgery.

  • Also tell your doctor if you have any allergies or other health problems. This includes recent illnesses, especially any bleeding problems. 

  • You will need to stop eating and drinking for a set amount of time before the surgery. Be sure to follow these instructions carefully.

The Day of the Surgery

  • Most exploratory laparotomies are done urgently or emergently. 

  • You will be evaluated for risks of heart, lung, or other problems during surgery. 

  • You may need to change into a hospital gown.

  • Before the surgery begins, an IV line is put into a vein in your arm or hand. This line supplies fluids and medications.

  • To keep you free of pain during the surgery, you are given general anesthesia. This medication puts you in a state like deep sleep during the surgery. 

  • A tube may be placed through your mouth and into your throat to help with breathing. Also, monitors are attached to your body. These record your vital signs, such as heart rate and blood pressure, during the surgery. 

  • A thin tube called a catheter is placed into your bladder. This tube drains urine from your bladder during the surgery.

During the Surgery

  • The skin over the abdomen is cleaned.

  • An incision is made in the abdomen.

  • The tissue, blood vessels, and organs in the abdomen are carefully examined and checked for problems.

  • Tissue samples (biopsy) may be removed and sent to a lab for study.

  • If the cause of the problem is found, treatment may then be done, if needed.

  • When the surgery is complete, the incision is closed with stitches (sutures) or staples. A drain may be placed in the abdomen to remove any excess fluids.

After the Surgery

  • You will be taken to a room to rest until you have recovered from the anesthesia. Nurses will monitor your condition. When you are more awake and alert, you will be moved to another room.

  • Medications are given to help prevent infection and to manage pain, if needed.

  • You will not be given food or drink until your bowels start to work normally again. This may take a few days.

  • You will need to get up and walk around as soon as you are able. This helps to prevent blood clots.

  • Also, you may be given breathing exercises to do. These help prevent pneumonia.

  • The tube to drain urine is usually removed within a few days.

  • If a drain was used for your incision, this is also removed.

  • You will be allowed to go home when the doctor confirms there are no issues of concern.

  • Arrange for an adult family member or friend drive you home.

  • Before leaving, make sure you have all the prescriptions and home care instructions you will need. Also, make sure you have a contact number for your doctor or hospital. This is in case you have problems or questions after the surgery.

  • Do not lift anything greater than 5 pounds for about 6 weeks. This allows time for tissue to heal, and prevents occurrence of hernia.

 

When to Call the Doctor

After you get home, call the doctor if you have:

  • Fever of 101.5°F (38.5°C) or higher

  • Increased pain, redness, swelling, bleeding, or drainage at the incision site

  • Pain that cannot be controlled with medications

  • Swelling of the abdomen

  • Diarrhea or constipation that does not get better within 2 days

  • Bloody or black, tarry stools

  • Problems or pain with urination

  • Chest pain, shortness of breath, or cough that won’t go away

  • Nausea and vomiting

  • Dizziness or fainting

  • Swelling or pain in the leg

Follow-Up

Recovery time will vary for each person. It may take as long as 4 to 6 weeks. You will need to see your doctor for follow-up. This is to remove any sutures or staples and to check your healing progress.

 

Risks and Possible Complications of Exploratory Laparotomy

These vary depending on the reason for the surgery. The most common risks and possible complications include:

  • Bleeding

  • Infection

  • Failure to find the cause of the problem; more surgery or other treatments may be needed

  • Poor healing of the incision

  • Damage, injury, or problems with the bowels

  • Risks of anesthesia

Online Medical Reviewer: Hanrahan, John, MD
Online Medical Reviewer: MMI board-certified, academically affiliated clinician
Date Last Reviewed: 3/30/2014
© 2000-2014 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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