Let's learn about an abdominal operation? Laparotomy surgery is simple

Sometimes a doctor may tell you, "You need to have an abdominal operation." It's normal to feel a little scared and nervous when you hear that. The medical name for this type of surgery, which involves opening the abdomen, is "laparotomy." So let's talk about this today, as if we were talking to a friend, in a way that will make all your worries go away.

Simply put, what is a laparotomy?

A laparotomy is a surgical procedure that opens up your abdominal cavity, which is where your abdominal organs are located. Think of it like opening the hood of a car to check the engine to see what's wrong. Doctors perform this procedure to directly examine the organs inside your abdomen.

This can happen in two main ways:

1. As an exploratory surgery: Sometimes, even scans cannot find the cause of your stomach pain or bleeding inside your stomach. In such cases, doctors perform this surgery to find out what is really going on inside. At that time, a small piece of tissue (biopsy) may be taken for examination.

2. As a therapeutic surgery: Sometimes this surgery is performed to treat a medical condition. For example, it may be necessary to remove a ruptured appendix, remove a cancerous tumor, or remove an entire organ.

What is the difference between Laparotomy and Laparoscopy?

You've probably heard of "keyhole surgery." That's what laparoscopy is. Although both of these methods are used to look inside the abdomen, there's a big difference between the two. Let's understand that clearly.

Why do we need a laparotomy?

A doctor usually only resorts to major surgery like this when there are no other options. There are several main reasons:

• Unexplained stomach pain: When scans cannot find the cause of persistent stomach pain or bloating.
• Intra-abdominal bleeding: Stop intra-abdominal bleeding due to an accident or other cause.
• Cancer stages: Remove a cancerous tumor, or see how far the cancer has spread in the stomach (Cancer Staging).
• Emergency situations: For example, when appendicitis is about to burst, or when there is a hole in the intestine.
• Cesarean section (C-section): A cesarean section, performed for a planned or emergency delivery, is also a type of laparotomy.
• Organ removal: Removal of an organ, such as the spleen or uterus, due to a medical condition.

What organs are examined in this surgery?

Opening the abdomen allows the doctor to examine many major organs. Some of these include:

• Stomach
• Small and large intestines (Intestines)
• Appendix
• Spleen
• Pancreas
• Liver
• Gallbladder
• Kidneys, adrenal glands and ureters
• Bladder
• Female reproductive organs (uterus, fallopian tubes, ovaries)

What happens before the surgery?

Because a laparotomy is a major surgery, there are several steps you can take to prepare for it. Some of these steps may not be possible during an emergency surgery.

• Informed consent: The doctor will explain everything to you about the surgery, its risks, and alternative treatments. Then, they will obtain your written consent.
• Physical examination: Blood tests and X-rays are done to check your health. It is very important to inform the doctor about the medications you are taking and any other illnesses you may have.
• Bowel prep: You may be given a laxative or enema to clean out your bowels the day before surgery. You will also need to fast for a few hours before surgery.
• Sterilizing: Before surgery, the abdominal area is thoroughly washed with an antiseptic soap. Sometimes, hair in the area may also be removed.

What happens during and after the surgery?

The surgery is performed under general anesthesia, so you won't feel any pain. The doctor makes an incision in your abdomen that can be anywhere from 3 to 12 inches long. After that, the necessary tests or treatments are performed, and the incision is stitched back together. The surgery can take several hours.

After the surgery, you will be taken to a post-operative room. Your heart rate and blood pressure will be monitored until you regain consciousness. During this time, you may have several tubes in your body:

• An IV line: This is inserted into a vein and delivers sedatives, antibiotics, and saline.
• Nasogastric tube: Remove fluid from the stomach.
• Urinary catheter: To drain urine.

You will be given painkillers to control the pain. During the first few days in the hospital, you will be helped to walk around a bit with the help of the nurses. This is very important to prevent blood clots and lung infections.

What are the risks of this surgery?

Like any major surgery, laparotomy can carry some risks, but not everyone experiences these.

• Unintentional damage to other nearby organs.
• Excessive bleeding due to damage to blood vessels.
• Infection of the incision and delayed healing.
• Permanent numbness in some areas around the incision due to nerve damage.
• Hernia in the incisional hernia.
• There is a small chance that a condition like bowel obstruction will occur in the future due to abdominal adhesions.

How long does it take to heal?

This will vary depending on your general health and the extent of the surgery performed.

• It usually takes about 6 weeks for the incision to heal .
• A long scar is left across the stomach, but it gradually fades over time.
• Depending on the nature of your job, you may be able to return to work after 6 weeks.
• It will take a few more months before you can lift weights or do strenuous exercise.
• It can take up to two years for the strength of your abdominal muscles to return to the level they were before surgery. Regular exercise can help with this.

After you go home, when do you need to talk to the doctor?

It is very important to monitor your recovery after you go home. If you have any of the following symptoms, inform your doctor immediately or go to the hospital's Emergency Department (ETU).

A laparotomy is not something to be afraid of, it is often a necessary procedure to save your life or to help you recover. Although the recovery time is a bit longer, by following your doctor's instructions exactly, you can recover quickly.

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