About Exploratory Laparotomy
This information is intended for general information only and should not be considered as medical advice on the part of Health-Tourism.com. Any decision on medical treatments, after-care or recovery should be done solely upon proper consultation and advice of a qualified physician.
What is a Laparotomy?
“Laparotomy” is the medical term for opening the abdomen
surgically. An “exploratory”
laparotomy is to investigate and treat the cause of an abnormality
that is unknown via conventional imaging and laboratory studies. Since such
surgery has risks, if a patient has already undergone the risk of surgery,
there is a mindset that that all things to resolve preoperative problems be
performed while in the surgery, which converts the exploratory laparotomy into
a “therapeutic laparotomy.” For example, if it is being done for pelvic pain
and a cyst on the ovary is discovered to be the cause, the cyst should be
removed at the same time.
When is a Laparotomy
There are many reasons that laparotomies are performed.
There are necessary ones—as with malignancies; and then there are indicated but
not necessary ones—such as for investigating pain or reasons for infertility.
The most common reasons for laparotomy include:
pain, which often has mysterious causes until laparotomy.
which requires ruling out malignancy or endometriosis.
or removal of the uterus.
Suspicion of malignancy,
which requires ruling out or confirmation.
To diagnose and treat endometriosis,
a cause of pain and infertility.
To remove uterine
fibroids, a cause of pain and infertility.
when it is life-threatening.
How is a Laparotomy
Laparotomy is a surgery in which there is access to the abdominal
cavity via opening the layers of the abdominal wall in compliance with sterile
procedure—that is, in an operating room specifically designed to assure a clean
environment and stocked adequately for any unforeseen emergency. Since it is a
surgery, it is important that the facility in which laparotomy is performed
have anesthesia available via an anesthesiologist and a blood readily available
in the unlikely event it is needed quickly for any unintended blood loss. This
means a facility with 24-hour anesthesia in-house and a blood bank.
What is the
Difference Between a Laparotomy and a Laparoscopy?
is used to gain access to the abdominal organs for surgery using small
incisions through which a lighted scope is inserted for visualizing the area
undergoing surgery, and the additional small incisions for small instruments attached
to “poles,” which are inserted and manipulated through those small incisions.
However, because laparoscopy also involves entrance into the abdominal cavity,
it is still considered a laparotomy, with the same risks included. However, due
to the minimal manipulation of tissue, complications, healing, and recovery are
much less, hence its popularity.
whether a laparotomy is performed the traditional way or via laparoscopy?
This is determined beforehand by the complexity of the
surgery. If the limited access via small incisions and limited instrumentation
means the goals of laparotomy cannot be accomplished, a “traditional incision”
laparotomy is done, with either a vertical midline incision or a horizontal
(“bikini”) incision. For example, if there is a solid 8-cm mass on the ovary,
this will prevent removal through a 1-cm incision.
How Do You Prepare?
Because laparotomy enters a major body cavity, you must be
evaluated medically with a full exam, lab work
including blood and ECG, a pregnancy test, and a chest X-ray. The blood work
should include clotting studies. You should refrain from taking any blood-thinners—even
aspirin—for a week before. This may include certain herbal
items over-the-counter (OTC), so you must provide a complete list of
what you take—prescription and OTC—to your surgeon.
If you’ve had surgery before and suffered
complications—including those from anesthesia—you must inform your surgeon.
Preparing for laparotomy means nothing to eat or drink at
least 6 hours before surgery, because a full stomach, under anesthesia, can
risk aspiration of stomach contents into your lungs. Also, an antibacterial
wash the night before will help reduce infection.
How Does Medical
Tourism Apply to Laparotomy?
When undergoing a laparotomy abroad, the key to safely
returning home is being adequately recovered enough to safely travel. The three
all-encompassing risks of any surgery involve one of 3 things:
Damage to other structures
during the surgery.
Usually, the progression of complications is
will occur in the first 24 hours;
damage to other structures
will become evident within 24 hours (as with bladder complications) or as long
as a week (as with bowel complications);
infection will be the risk
after that, with lungs (first), bladder (second), blood clots (third), and
wound infection (the last to occur). Nevertheless, this whole range runs its
course of risk after about a week.
To be considered safe to travel, therefore, a patient with
an uneventful postoperative course should wait for at least 10 days. Of course,
if any of the above complications occur, this will delay travel accordingly.
Days admitted : To be considered safe to travel, therefore, a patient with an uneventful postoperative course should wait for at least 10 days. Of course, if any of the above complications occur, this will delay travel accordingly.
Anesthesia : Usually general (inhalation) anesthesia. Sometimes a spinal or epidural anesthetic will suffice, but these can be patchy in some areas of your body. General anesthesia is guaranteed coverage for the p
Recovery : Although you will get past the postoperative complication risks cited above—and be able to travel—within 10 days to 2 weeks, it takes about 4-6 weeks to really feel “yourself” again. Return to work is feasible after about a month, but you may still feel “washed out.”
Risks : When undergoing a laparotomy abroad, the key to safely returning home is being adequately recovered enough to safely travel. The three all-encompassing risks of any surgery involve one of 3 things:
2. Damage to other structures during the surgery.
After care : Follow-up: before returning home,
• report to your doctor if there is any bleeding;
• report any fevers, trouble breathing, painful calves (blood clots), pus-like (“purulent”) discharge from the incision repair or separation of the incision repair;
• report any abdominal distension or unusual pain (some postop pain is expected, but it should get better every day, not change course and get worse);
• report anything strange like urinary complaints or mental status changes.
After returning home, have a full postoperative evaluation by the same type of surgeon who did the surgery abroad.
Learn more about Exploratory Laparotomy