Exploratory Laparotomy Paper

Angela Withers

June 2, 2013

LeAnne Shirley

Exploratory Laparotomy Paper

Exploratory Laparotomy

An exploratory laparotomy is performed to obtain information that cannot be obtained in other methods or for therapeutic procedures. It is usually performed in patients that have unexplained abdominal pain or cramps, abdominal trauma, or occasionally for staging of malignancy. An exploratory lap may be done as a therapeutic procedure or to confirm a diagnosis. An exploratory laparotomy is usually done for emergency surgeries and when the patient cannot undergo laparoscopic surgeries because of scar tissue, etc.

There are four primary indications for an exploratory laparotomy: Peritonitis, Intestinal Obstruction, Staging of Malignancy, and Chronic Abdominal Pain. In these conditions, an exploratory laparotomy is carried out both to diagnose and treat the condition.

Contraindications for this surgery would be patients who cannot go under general anesthesia, patients with advanced malignancy, peritonitis with severe sepsis, or any other comorbid conditions that may render the patient unfit for anesthesia. The patients’ physiological state is important in the outcome of an exploratory laparotomy.

The patient should be placed in the supine position, with arms abducted at right angles to the body. The patient should also have a nasogastric tube to decompress the stomach and an indwelling catheter to keep the bladder drained during the surgery. Patient should also have adequate anesthesia. The operating room should have anesthetic equipment, overhead lighting, ESU equipment, suctioning systems, and a standard laparotomy tray. The mayo setup and the back table should include the following: Clamps- four curved hemostats,