LAPAROTOMY

General Information

DEFINITION--Any surgical opening made into the abdomen.

BODY PARTS INVOLVED--Skin; abdominal muscles; peritoneum; abdominal organs.

REASONS FOR SURGERY

• Diagnostic examination of the abdominal organs.
• Collection of tissue samples for diagnosis.
• Closure of hernias in the abdominal wall.
• Repair or removal of abnormal tissue.
• Removal of diseased organs.
• Correction of unsightly or disfiguring abnormalities.

SURGICAL RISK INCREASES WITH

• Stress; obesity; smoking.
• Excess alcohol consumption.
• Poor nutrition.
• Recent acute infection.
• Chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--General surgeon; obstetrician-gynecologist; gastroenterologist.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of kidneys and chest; ECG (See Glossary).
• After surgery: Blood studies.

ANESTHESIA--Spinal or general anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen. The abdominal muscles are separated, and the peritoneum is opened.
• Blood vessels cut during the surgery are clamped and tied.
• Wound edges are retracted with a special instrument.
• Fluid in the abdominal cavity is often removed for laboratory examination.
• The abdominal organs are examined. Other surgeries may be performed at this time.
• Samples of suspicious tissue are gathered or diseased areas are treated.
• The peritoneum is closed, and the muscles are reconstructed with heavy sutures.
• The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Incisional hernia.
• Abscess formation.

AVERAGE HOSPITAL STAY--5 to 7 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 4 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the chance of deep--vein blood clots.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. Resume sexual relations when doctor's exam reveals complete healing. > Resume driving about 3 weeks after returning home.

DIET--Nasogastric suction is frequently required followed by a clear liquid diet until the gastrointestinal tract functions again. Then eat a well--balanced diet to promote healing. Your doctor may prescribe another diet, depending on your condition.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience new symptoms, such as nausea, vomiting, constipation, abdominal swelling or severe pain.