1. General Surgery
  2. Abdominal Pain (Exploratory Surgery)

Abdominal Pain

Exploratory laparotomy is surgery to open up the belly area (abdomen). This surgery is done to find the cause of problems (such as belly pain or bleeding) that testing could not diagnose. This surgery uses one large cut (incision). The surgeon can then see and check the organs inside the abdomen. If the cause of the problem is found during the procedure, then treatment is often done at the same time. In some cases, a minimally invasive surgery called exploratory laparoscopy may be used instead. That method uses a camera and several small incisions. 

Reasons for the Surgery
Organs that may be looked at during exploratory laparotomy include:
Liver Large intestine (colon or large bowel)
Gallbladder Appendix
Spleen Ovaries, fallopian tubes, and uterus
Pancreas Lymph nodes
Kidneys Abdominal blood vessels
Stomach Membranes that line the abdominal cavity
Small intestine (small bowel)
Surgery Process
Before the Surgery

The surgery takes place in a hospital. It is done by a surgeon. To prepare for the surgery, do the following:

  • Tell your provider about any medicines you're taking. This includes over-the-counter medicines, prescription medicines, herbs, street drugs, herbs, vitamins, and other supplements. You may need to stop taking some or all of them for a time before the surgery.
  • Tell your provider if you drink alcohol. This is very important if you are a heavy drinker. Alcohol withdrawal can be life-threatening, so be honest with your provider.
  • Also, tell your provider if you have any allergies or other health problems. This includes recent illnesses, especially any bleeding problems.
  • Stop smoking. Don't smoke on the day of surgery.
  • Follow any directions you are given for not eating or drinking before surgery.
Day of the Surgery
  • You will be checked for risks of heart, lung, or other problems during surgery. 
  • You may need to change into a hospital gown.
  • Before the surgery begins, an IV (intravenous) line is put into a vein in your arm or hand. This line supplies fluids and medicines.
  • You will be given medicine (general anesthesia) to keep you free of pain. This medicine puts you in a state like deep sleep during the surgery. 
  • A tube may be placed through your mouth and into your throat to help with breathing. Also, monitors are attached to your body these record your vital signs, such as heart rate and blood pressure, during the surgery. 
During the Surgery
  • The skin over your belly is cleaned.
  • An incision is made in your belly.
  • The tissue, blood vessels, and organs in your belly are carefully looked at and checked for problems.
  • Tissue samples (biopsy) may be removed and sent to the lab for study.
  • If the cause of the problem is found, treatment may be done then, if needed.
  • When the surgery is done, the incision is closed with stitches (sutures) or staples. A drain may be placed in the abdomen to remove any extra fluids.
After the Surgery
  • You will be taken to a room to rest until you have recovered from the anesthesia. Nurses will closely watch your condition. When you are more awake and alert, you will be moved to another room.
  • Medicines are given to help prevent infection and to manage pain if needed.
  • You will not be given food or drink until your bowels start to work normally again. This may take a few days.
  • You will need to get up and walk around as soon as you are able. This helps to prevent blood clots.
  • Also, you may be given breathing exercises to do. These help prevent pneumonia.
  • You will be able to go home when the provider says there are no issues of concern.
  • Arrange for an adult family member or friend to drive you home.
  • Before leaving, make sure you have all the prescriptions and home care instructions you will need. Also, make sure you have a contact number for your provider or the hospital. This is in case you have problems or questions after the surgery.
  • Avoid constipation. Take fiber and any stool regimen that was recommended.
  • Do not lift anything heavier than 5 pounds for about 6 weeks. This gives the tissue time to heal and can prevent a hernia.
Follow-Up

Symptoms

After you get home, call your healthcare provider if you have:

  • Fever of 100.4°F (38.0°C) or higher, chills, or as advised by your provider
  • Increased pain, redness, swelling, bleeding, or drainage at the incision site
  • Pain that cannot be controlled with medicines
  • Swollen belly
  • Diarrhea or constipation that does not get better within 2 days
  • Bloody or black, tarry stools
  • Problems or pain with urination
  • Chest pain, shortness of breath, or a cough that won’t go away
  • Nausea and vomiting
  • Dizziness or fainting
  • Swelling or pain in the leg

Follow-Up

Recovery time will vary for each person. It may take as long as 4 to 6 weeks. You will need to see your provider for a follow-up. This is to remove any sutures or staples and to check your healing progress.

Risks & Complications

These vary depending on the reason for the surgery. The most common risks and possible complications include:

  • Bleeding
  • Infection
  • Can't find the cause of the problem, so more surgery or other treatments may be needed
  • The Incision doesn't heal well
  • Damage, injury, or problems with the bowels
  • Risks of anesthesia

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