Exploratory laparotomy: what it is, when it is indicated and how it is done

Content:

Exploratory laparotomy, or exploratory, is a diagnostic test in which a cut is made in the abdomen region in order to observe the organs and identify the cause of a particular symptom or change in imaging tests. This procedure must be performed in the operating room with the patient under sedation, as it is an invasive procedure.

It is recommended that the person remains in the hospital so that they can be followed up and recover more quickly from the procedure, in addition to reducing the risk of complications, such as bleeding and infections.

When exploratory laparotomy is indicated

Exploratory laparotomy is performed for diagnostic purposes, being performed when there are some signs of changes in the abdominal organs.

It is usually an elective procedure, but it can also be considered in emergencies, such as major car accidents, for example. Therefore, this exam may be indicated in order to investigate:

  • Suspected abdominal bleeding;
  • Perforations in the intestine;
  • Inflammation of the appendix, intestine or pancreas;
  • Presence of liver abscesses;
  • Signs indicative of cancer, especially pancreas and liver;
  • Presence of memberships.

In addition, exploratory laparotomy can also be used to investigate some conditions in women, such as endometriosis, ovarian and cervical cancer, and ectopic pregnancy, for example. However, most of the time, instead of laparotomy, videolaparoscopy is performed, in which some small holes are made in the abdominal region that allows the passage of a medical instrument that is attached to a microcamera, allowing the visualization in real time without being need to make a larger cut. Understand how laparoscopy is performed.

During exploratory laparotomy, if any changes are observed, it is possible to collect a tissue sample and send it to the laboratory for a biopsy. In addition, if any problem is identified during the examination, a therapeutic laparotomy can also be performed, which corresponds to the same procedure but with the aim of treating and correcting what is altered.

how is it done

Exploratory laparotomy is performed in the operating room, with the patient under general anesthesia and lasts between 1 and 4 hours depending on the purpose of the exam. Anesthesia is important so that the person does not feel anything during the procedure, however it is normal that after the effect of the anesthesia wears off, the person feels pain and discomfort.

After application of anesthesia and onset of effect, a cut is made in the region of the abdomen whose size varies according to the purpose of the examination, and in some cases, a cut in almost the entire abdominal length can be performed. Then, the doctor performs the exploration of the region, evaluating the organs and verifying any changes.

Afterwards, the abdomen is closed and the person must remain in the hospital for a few days so that they are closely monitored and, thus, complications can be prevented.

Possible complications

As it is an invasive procedure that requires general anesthesia, there may be complications related to the procedure, as well as problems related to clotting, increased risk of bleeding and infections, hernia formation and damage to an organ located in the abdominal region.

Although rare, these complications are more frequent when emergency exploratory laparotomy is needed or when the patient is smokers, people who consume alcohol frequently or who have chronic diseases, such as diabetes or obesity, for example. Therefore, in the presence of any of these factors, it is important to inform the doctor so that the procedure is performed with caution and, thus, complications are prevented.