Laparotomy, Exploratory Health Article

Author Info:
Stephanie Dionne Sherk, The Gale Group Inc., Gale, Detroit, 2004

Exploratory laparotomy is a method of abdominal exploration, a diagnostic tool that allows physicians to examine the abdominal organs. The procedure may be recommended for a patient who has abdominal pain of unknown origin or who has sustained an injury to the abdomen. Injuries may occur as a result of blunt trauma (e.g., road traffic accident) or penetrating trauma (e.g., stab or gunshot wound). Because of the nature of the abdominal organs, there is a high risk of infection if organs rupture or are perforated. In addition, bleeding into the abdominal cavity is considered a medical emergency. Exploratory laparotomy is used to determine the source of pain or the extent of injury and perform repairs if needed. Laparotomy may be performed to determine the cause of a patient's symptoms or to establish the extent of a disease. For example, endometriosis is a disorder in which cells from the inner lining of the uterus grow elsewhere in the body, most commonly on the pelvic and abdominal organs. Endometrial growths, however, are difficult to visualize using standard imaging techniques such as x ray, ultrasoundtechnology, or computed tomography (CT) scanning. Exploratory laparotomy may be used to examine the abdominal and pelvic organs (such as the ovaries, fallopian tubes, bladder, and rectum) for evidence of endometriosis. Any growths found may then be removed. Exploratory laparotomy plays an important role in the staging of certain cancers. Cancer staging is used to describe how far a cancer has spread. A laparotomy enables a surgeon to directly examine the abdominal organs for evidence of cancer and remove samples of tissue for further examination. When laparotomy is used for this use, it is called staging laparotomy or pathological staging. Some other conditions that may be discovered or investigated during exploratory laparotomy include:

cancer of the abdominal organs peritonitis (inflammation of the peritoneum, the lining of the abdominal cavity) appendicitis (inflammation of the appendix) pancreatitis (inflammation of the pancreas) abscesses (a localized area of infection) adhesions (bands of scar tissue that form after trauma or surgery) diverticulitis (inflammation of sac-like structures in the walls of the intestines) intestinal perforation/ internal bleeding / foreign bodies (e.g., a bullet in a gunshot victim) ectopic pregnancy (pregnancy occurring outside of the uterus)