A laparotomy is open abdominal surgery. It can help your surgeon both diagnose and treat issues. An exploratory laparotomy opens you up to find the source of an issue in your abdomen, and hopefully fix it, too. You may also have a scheduled operation to remove an organ, deliver a baby or stage and treat cancer.
A laparotomy is a surgical procedure that opens up your abdomen to expose your organs.
Sometimes, a laparotomy is exploratory — a way for your surgeon to see what’s going on inside your body and possibly take tissue samples in order to diagnose your condition. It can also be therapeutic — a way of treating some conditions. You may need open surgery to remove an organ or to manage a critical condition, or your surgeon may find and fix a problem while they’re exploring.
The term “laparotomy” actually refers to the incision through your abdominal wall that opens up your peritoneal cavity — the cavity that includes your abdomen and pelvis. But you’ll often hear the term used to describe an open exploratory procedure. Other terms for laparotomy include “celiotomy” (an incision into your abdomen) and “peritoneotomy” (an incision into your peritoneal cavity).
Laparotomy and laparoscopy are two different methods for surgically exploring the inside of your abdomen.
Laparoscopic surgery is an alternative to open surgery. Instead of opening up your abdomen to expose your organs, laparoscopic surgery works by inserting a laparoscope, a tiny lighted camera, through a small “keyhole” incision in your abdomen. Your surgeon operates through other keyholes, using the camera as a guide. A laparoscopy is an exploratory surgery similar to a laparotomy, using a laparoscope.
Each method has its benefits and drawbacks. Laparoscopy is less invasive and easier to recover from, making smaller wounds and leaving smaller scars. However, it requires special training and equipment, and it takes longer, which may not work in an emergency. A laparotomy is a standard procedure that any hospital can provide. In certain cases, it’s also more practical for managing critical conditions.
Your surgeon might need to explore your peritoneal cavity to find the source of a problem, such as unexplained abdominal pain or internal bleeding, if they haven’t been able to find it on imaging tests. They might need access to everything if they don’t know where the issue is located or how widely it might be spread. They might choose laparotomy over laparoscopy if your condition appears urgent.
Laparotomy is often an emergency procedure, but not always. You might have a laparotomy for a planned or unplanned C-section. Your surgeon might schedule a laparotomy to remove an organ or to remove cancer. It’s also helpful for cancer staging, to find out how far cancer may have spread from its original location. This is a “staging laparotomy.” They also might need to take tissue samples for biopsy.
Your surgeon might need to look at your:
Some examples include:
Yes. Whether it’s an exploratory laparotomy or it’s for a limited purpose, such as removing an organ, opening up your peritoneal cavity is major surgery. The incision will be long and deep, and many layers of your tissue will have to be repaired and healed. You’ll recover in stages, in the hospital and at home. The specifics of your condition and what happens during the procedure will also affect your recovery.
Preparation before surgery includes:
A laparotomy involves a large incision of three to 12 inches into your abdominal cavity. The specifics of the incision, and what happens after, will depend on the purpose of your laparotomy. In general, you can expect to be in surgery for several hours. You may have various tubes installed in different parts of your body to deliver and drain fluids, and these will stay in place for several days. These may include:
A laparotomy for a specific purpose, such as an exploratory laparotomy or a staging laparotomy, might have its own set of standardized steps. But often, your surgical team won’t know all the steps they’ll need to do until they’re in surgery. So, not every variation of the procedure is a standardized type.
There are also different types of laparotomy incisions that your surgeon might use for different purposes. While a midline incision through your abdomen is most common, giving your surgeon access to all of your organs, your surgeon might use a different incision to focus on the organs in a specific area.
The incisions cut through layers of skin, body fat and fascia (connective tissue) until they reach the abdominal muscles. Some incisions avoid the muscles entirely, some split or separate them to avoid them, and some cut through layers of muscle. Examples of different abdominal incisions include:
When you come out of surgery, you’ll transfer to a postoperative room, where healthcare providers will monitor your vital signs until you wake up. Then, they’ll move you to a recovery room for the next few days. The tubes inserted into your body during surgery will remain in place to drain and deliver fluids, and you’ll have pain relief as needed. A healthcare provider will assist you in standing up and walking around a bit each day.
Your provider may give you deep breathing and muscle exercises to do in the hospital and when you return home. These help prevent blood clots and chest infections. Your provider will also instruct you on caring for your incision at home. It’s common for your bowels to be temporarily paralyzed after abdominal surgery (paralytic ileus). Your healthcare provider can give you an enema or medications if necessary to help you poop.
Laparotomy helps surgeons diagnose and treat a wide range of conditions, often at the same time. All surgeons can perform a laparotomy, and they can adapt the procedure with different approaches to fit the situation. In general, surgeons only use laparotomy when they need to. It might be necessary for speed or accessibility or because of the serious nature of your condition. When needed, it can be life-saving.
Possible complications include:
This can vary, depending on your overall health and stamina and how extensive your operation was. It takes an average of six weeks for the incision to heal. It will leave a long scar across your abdomen, which should fade over time. You may have areas of numbness in your abdomen, due to nerve damage. This should improve over the following months, but sometimes, some numbness remains.
You may return to work after the incision has healed, depending on how physical your job is. You won’t be ready for moderate exercise or lifting for a few months. It takes about two years for your core abdominal strength to return to where it was before the surgery. Regular exercise can help with this, but you’ll need to take it slowly. Your surgeon can give you more specific instructions about exercise.
Your scar should gradually fade and flatten over the next three to six years, depending on genetics and other factors. You can help by taking good care of your incision while it heals and protecting the scar from UV rays afterward. Your surgeon may suggest topical treatments to help diminish your scar.
After you go home, call your provider if you notice:
A note from Cleveland Clinic
A laparotomy allows your surgeon to see and examine many organs at once, which is important when your condition may affect any or many of them. It also allows them to treat conditions urgently when they find them. It’s not a small matter to have open surgery, but someday, you may need it. When the emergency is over, your healthcare team will help guide you through the long recovery process.
Last reviewed by a Cleveland Clinic medical professional on 02/27/2023.
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