Exploratory laparotomy

An exploratory laparotomy is a general surgical operation where the abdomen is opened and the abdominal organs are examined for injury or disease. It is the standard of care in various blunt and penetrating trauma situations in which there may be life-threatening internal injuries. It is also used in certain diagnostic situations, in which the operation is undertaken in search of a unifying cause for multiple signs and symptoms of disease, and in the staging of some cancers. During an exploratory laparotomy, a large incision is made vertically in the middle of the abdomen to access the peritoneal cavity, then each of the quadrants of the abdomen is examined. Various other maneuvers, such as the Kocher maneuver, or other procedures may be performed concurrently. Overall operative mortality ranges between 10% and 20% worldwide for emergent exploratory laparotomies. Recovery typically involves a prolonged hospital stay, sometimes in the intensive care unit, and may include rehabilitation with one or more therapies. TOC With the development of less invasive laparoscopic surgical techniques, exploratory laparotomies are less common than they used to be. A database that tracks exploratory laparotomies performed in the United Kingdom estimates that about 30,000 are done across England and Wales each year out of a population of 59.5 million people. Reasons why a patient may require an exploratory laparotomy include: Acute blunt or penetrating trauma with evidence of internal bleeding (a positive focused assessment with sonography for trauma, diagnostic peritoneal lavage, or CT scan), unstable blood pressure, or evisceration Acute abdomen with evidence of inflammation of the abdominal lining or the abdominal organs, gastrointestinal bleeding, or gastrointestinal perforation Cancer staging, especially ovarian cancer and Hodgkin and non-Hodgkin lymphoma Inability to access the part of the abdomen where a surgical disease is using a less invasive approach, or a lack of laparoscopic equipment, technology, or training A vertical cut, or incision, is made in the middle of the abdomen.