Laparotomy or laparotomy is a surgical procedure by making an incision in the abdominal wall. Laparotomy is performed to diagnose and treat problems with organs in the stomach, such as digestive problems and disorders of the liver, pancreas, spleen, and bile.
Not only internal organs, laparotomy or coeliotomy It can also be done to examine the blood vessels and tissues in the abdomen. The size and location of the incision made depends on the disease suffered by the patient. This procedure generally requires general anesthesia (general anesthesia).
Purpose of Laparotomy
Laparotomy is generally recommended by doctors if a physical examination and imaging tests (such as CT scans and X-rays) of the abdomen have not provided an accurate diagnosis or result.
With a laparotomy procedure, the doctor will look at the condition of the inside of the abdomen to find out what is the problem or the cause of the patient's complaints. Immediate treatment will also be carried out if needed.
This surgery can be used to diagnose and treat a variety of ailments, such as:
- Liver cancer, pancreatic cancer, bowel cancer, or ovarian cancer.
- Gallstones.
- Acute appendicitis.
- Holes in the intestines (bowel perforation).
- Inflammation of the lining of the abdominal wall (peritonitis).
- Diverticulitis.
- Abdominal injury (abdominal trauma).
- Infection, injury, or enlargement of the spleen and liver.
- Gastrointestinal TB.
- Endometriosis.
- Scar tissue in the abdomen or adhesions to organs in the abdomen.
- Pregnancy outside the uterus (ectopic pregnancy).
- Inflammation of the pancreas (pancreatitis) acute or chronic.
- Liver abscess.
Laparotomy Procedure
As mentioned above, a laparotomy is a type of surgery that is performed under general anesthesia (general anesthesia). Under general anesthesia, the patient will fall asleep and feel no pain during the operation. Following are the steps of the laparotomy procedure:
1. Preoperative preparation procedure
Some of the preparations that need to be done before undergoing laparotomy surgery are:
- The patient will undergo a series of examinations, including physical and supporting examinations, such as X-rays and complete blood counts.
- The doctor will ask if the patient is taking drugs, supplements, or herbal medicines, and has a history of certain drug allergies.
- Undergo hospitalization if needed.
- Fasting a few hours before the operation is performed. The anesthesiologist or surgeon will determine when the patient begins fasting.
2. Operation procedure
During the laparotomy procedure, here are some things that will happen:
- The skin in the abdominal area to be cut will be covered with an antiseptic solution to prevent the risk of infection.
- The surgeon will make a single incision in the skin and abdominal muscles so that the organs underneath can be seen clearly.
- The organs are carefully examined, such as for infection, inflammation or tumors.
- Once the problem is found, the surgeon can immediately address the problem on the spot, for example sewing a perforated intestine. However, it is possible that a second operation is needed.
- The doctor will sew back the incision in the skin and abdominal muscles, after the laparotomy is complete.
3. Postoperative procedures
After the laparotomy surgery procedure is completed, there are several things that the patient needs to undergo, namely:
- Observed in a special recovery room, to wait for the anesthetic effect to wear off.
- A small tube is attached from the nose to the stomach, which functions to clear gastric juices and help rest the stomach.
- A catheter is placed in the urinary tract to help drain urine.
- An infusion tube is attached as a source of fluid, because usually the patient is not allowed to eat and drink for several days after surgery.
- Taking painkillers, because the surgical scars will usually be painful and make the patient uncomfortable.
- Practice walking as soon as possible, or when your body is strong enough. This is to avoid the risk of blood clots.
- Stay in the hospital for a few days after the procedure. To fully recover and be able to carry out activities as before, it may take about 6 weeks.
Risk which Can Appear
Just like other surgeries and treatments, laparotomy surgery also has a risk of complications, including:
- Bleeding
- Infection
- Internal organ damage
- Formation of scar tissue in internal organs
- Reaction to drugs
The recovery period from laparoscopic surgery depends on the severity of the disease, age, complications after surgery, and the patient's health condition. If there are complications or worsening of the condition after surgery, then recovery tends to be longer.
In addition to the usual laparoscopic procedure, currently there is an alternative to laparotomy called laparoscopy. This procedure has the advantage of having minimal incisions so that the healing process becomes faster.
By undergoing a laparotomy, it is hoped that organ disorders in the abdomen can be found and treated as soon as possible. If you feel pain in the abdomen that is very severe, do not hesitate to go to the surgeon. The doctor will determine the steps of treatment, including whether to undergo a laparotomy.