What is Laparotomy?

A laparotomy is a surgical incision (cut) into the abdominal cavity. This operation is performed to examine the abdominal organs and aid diagnosis of any problems, including abdominal pain. In many cases, the problem – once identified – can be fixed during the laparotomy. In other cases, a second operation is required. Another name for laparotomy is abdominal exploration.

Surgical investigation of abdominal pain

A common reason for a laparotomy is to investigate abdominal pain, but the procedure may be required for a broad range of indications. The abdominal organs include the digestive tract (such as the stomach, liver and intestines) and the organs of excretion (such as the kidneys and bladder). Your surgeon may need to operate to find out the exact cause of your complaint. For example, they may need to pinpoint the cause of internal bleeding in the digestive tract or find out where your bowel may be perforated (burst), before treatment can commence.

Laparotomy Procedure

A laparotomy is performed under general anaesthesia. The surgeon makes a single cut through the skin and muscle of the abdomen, so that the underlying organs can be clearly viewed. The exposed organs are then carefully examined. Once diagnosed, the problem may be fixed on the spot (for example, a perforated bowel may be repaired). In other cases, a second operation may be needed. Once the laparotomy is complete, the muscle of the abdominal wall and the overlying skin are sutured (sewn) closed.

Uses

Doctors may use laparotomy for a variety of reasons. It can help them diagnose or treat abdominal conditions, such as:

• abdominal pain


• Abdominal trauma


• Peritonitis, which is an inflammation of the inner lining of the abdomen


• A perforated organ in the abdomen


• Infection in the abdomen


• Internal bleeding


• The spread of conditions such as cancer or endometriosis

Females may have a laparotomy for a hysterectomy, which is the removal of the uterus, or for the removal of the ovaries or fallopian tubes.

Types

There are different types of incisions for laparotomy:

Midline: This incision runs down the middle of the abdomen. It is the standardTrusted Source incision for laparotomy. If people only need surgery for their upper abdomen, the incision will not run the whole length of the abdomen.

Paramedian: A paramedian incision is a vertical cut that runs to one side of the midline. It allows a surgeon to access the kidneys and adrenal glands.

Pfannenstiel: Surgeons may use a Pfannenstiel incision to access the pelvic region, such as in the case of an emergency cesarean delivery.

Subcostal: A subcostal incision is a diagonal cut across one side of the upper abdomen. A surgeon may use a subcostal incision to access the gallbladder or liver on the right side or the spleen on the left side.

Rooftop (chevron): If the surgeon makes a subcostal incision on each side of the body, the incisions may meet in the middle to make a rooftop incision.