Abdominal surgery? Let's talk about laparotomy.

Have you or someone you know ever been told by a doctor to "cut open the stomach" for a stomach problem? Or have you ever heard that a major operation is needed to find a problem inside the stomach after an accident, or to stop bleeding? In medicine, this surgery, which is performed in such cases, to open the abdominal cavity and examine the organs, is called a "laparotomy." This is a bit of a major surgery, so many people can be afraid of it. Therefore, let's talk about it simply and clearly today.

What exactly is a laparotomy?

Simply put, a laparotomy is a surgical procedure in which a surgeon opens your abdominal cavity (the hollow space inside your belly) to examine or treat the organs inside.

This can be done in two main ways:

1. For diagnosis (Exploratory Laparotomy): Sometimes, even if there is a problem like abdominal pain or internal bleeding, the cause cannot be found even with scans. In such cases, the surgeon performs this operation to really see and understand what is going on inside the abdomen. At that time, if necessary, a piece of tissue can be taken and sent for examination (`Biopsy`).

2. Therapeutic Laparotomy: Sometimes surgery is performed only after the problem is known. For example, this surgery is performed to remove a cancerous tumor, repair a damaged intestine, or remove an inflamed appendix.

What is the difference between Laparotomy and Laparoscopy?

Although both are abdominal surgeries, there is a big difference between the two. Many people confuse these two names. Let's see what the difference is.

In what cases is a laparotomy necessary?

There may be specific reasons why a surgeon may choose a laparotomy over a laparoscopy. This method is more practical, especially in an emergency situation where a quick intervention is needed.

Some situations in which a laparotomy may be necessary:

• To check for damage to internal organs after a severe abdominal injury.
• Peritonitis (infection of the abdominal cavity).
• Stomach or intestinal perforation or uncontrollable bleeding .
• To remove the abscess that had become severely inflamed and was about to burst.
• To remove the spleen when it bursts in an accident.
• To remove large ovarian cysts or endometriomas .
• To check and treat the condition and spread of endometriosis .
• Major surgeries such as the Whipple procedure for pancreatic cancer.
• To find out how far cancer, such as ovarian cancer or Hodgkin lymphoma , has spread in the body (Cancer staging).
• Planned or emergency cesarean section (`C-section`).

What happens before the surgery?

Since this is a major surgery, there are several things you need to prepare for beforehand.

1. Informed Consent

Your surgeon will explain the surgery, its risks and benefits, and alternative treatments to you clearly. They will understand all of this and obtain your written consent. In the event of an emergency, decisions will be made in consultation with the next of kin if the patient is unconscious.

2. Physical Assessment

The doctor will ask about your health, the medications you are taking, and any previous surgeries you have had. He will also do some basic tests, such as blood tests and X-rays, to see if you are fit to undergo general anesthesia.

3. Bowel Prep

Depending on the type of surgery, you may need to completely empty your bowels before surgery. You may be given a laxative formula or an enema. You may also be asked to fast or drink only liquids the day before surgery.

4. Sterilizing

Before the surgery, you may be asked to take a shower with an antiseptic soap. Or, the hospital staff will clean your abdominal area. They may also shave any hair in the area.

What happens after the surgery?

After the surgery, you will be taken to a postoperative room, where your heart rate and blood pressure will be monitored until you regain consciousness. Then you will be transferred to a ward and will have to stay in the hospital for a few days.

• Painkillers: Painkillers are given to control the pain of the wound.
• Tubes: IV lines and urinary catheters placed during surgery may remain in place for several days, depending on the need.
• Walking: Even if there is pain, you are encouraged to get up and walk slowly with the help of the staff. This is very important to prevent blood clots and lung infections.
• Breathing exercises: Deep breathing exercises are taught.
• Food: First, liquids are given, and then regular food is gradually introduced. Sometimes it takes a few days for the bowels to return to normal. This is called `Paralytic ileus` .

What are the risks of this surgery?

Like any major surgery, laparotomy has certain risks.

• Unintentional damage to other nearby organs.
• Excessive bleeding from injured blood vessels.
• Wound infection and delayed healing.
• Permanent numbness in some areas around the incision due to nerve damage.
• Hernia (hernia) occurs in connection with the incision.
• Scar tissue (abdominal adhesions) forms in the abdomen, leading to intestinal obstruction in the future.

How long does it take to heal?

This depends on your overall health and the complexity of the surgery.

• Wound healing: It usually takes about 6 weeks for the wound to heal completely.
• Scar: A long scar is left across the abdomen. However, this will gradually fade over time (within 3-6 years).
• Returning to work: Depending on the nature of your job, you may be able to return to work after the injury has healed. However, it is best not to do anything heavy, such as lifting weights, for a few months.
• Exercise: It can take up to two years for the strength of your abdominal muscles to return to normal. Therefore, exercise should be started very slowly and under medical supervision .

After you go home, if you have any of the following symptoms, you should call your doctor immediately .

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