LAPAROTOMY

What is laparotomy?

Laparotomy is a way of doing surgery by making a large cut on your abdomen (tummy area). The cut can be vertical (aka midline incision) or horizontal (aka bikini cut).

Why is a laparotomy done?

There are reasons you would have a laparoscopy. You might have this procedure if you have:

Abnormal bleeding
Fibroids
Endometriosis
Adenomyosis
Cancer of the uterus, ovary, cervix

My doctor says I need a laparotomy. What should I expect?

Depending on why you are having surgery, you will likely need 2-night stay in the hospital.

Once you are in the operating room:

You will be given a general anesthetic. This means that you will be asleep the entire surgery.
A tube will be placed in your throat to help you breathe.
A catheter will be inserted into your bladder. Depending on your surgery, it might be removed at the end of the procedure or the next day.
Your doctor will then make a cut on your abdomen to perform the surgery.
Once the surgery is completed, all the instruments are removed.
The incision is closed with stitches or staples.

Who will be involved in my surgery?

On the day of surgery, you will meet the surgical team. This will include:

Your doctor
Surgical assistants: these are usually trainees supervised by your doctor. They can include:
- Fellows (doctors who are licensed obstetricians and gynecologists and are doing extra training to perform minimally invasive surgery)
- Residents (doctors are training to become obstetricians and gynecologists)
- Medical students (these are students learning to become doctors)

Nurses
Anesthesiologist (doctors who put you to sleep during surgery)

What do I need to do to get ready for surgery?

No solid food 8 hours before surgery.

No clear fluid 4 hours before your Surgery.

How long will it take me to recover?

After you wake up from the general anesthetic, you will feel sleepy. Some patients might feel sick and vomit. You will need someone to drive you home.

For horizontal incisions, most women will recover by 6 weeks.
For vertical incisions, most women will recover by 8 weeks.
For a few days after the surgery, you might feel tired and have some discomfort.
You should still move around at home.
You will be sore around the cuts in your abdomen.
You will be given pain medication.
You might have a sore throat from the tube put in your throat during surgery. You can try throat lozenges to help with the sore throat.

What can I do after surgery?

You can shower 2 days after surgery.
Your doctor will let you know when you can get back to regular activities.
Usually, your doctor will recommend to avoid heavy activity for 6 weeks and may recommend to avoid sexual intercourse for 6 weeks.
Do not drive until you are no longer taking narcotic pain medication and you can move around.

When should I be concerned?

While it is normal to have some pain and bleeding after surgery, you should see your doctor or go to the emergency room immediately if you have the following:

Abdominal pain that is getting worse
Heavy vaginal bleeding (changing 2 to 4 pads over 2 hours)
Fever
Chest pain or difficulty breathing
Severe pain, swelling and redness in on or both legs
Unable to urinate
Severe nausea (feeling sick to the stomach) and vomiting

What are the risks of laparotomy?

Laparotomy is a safe procedure, but there is a risk of the following complications:

Bleeding at the cut site on the skin
Hernia at the cut site on the skin (a bulge caused by intestines pushing through the deeper layers of the abdominal wall)
Internal bleeding, rarely needing a blood transfusion
Infection
Injury to blood vessels, nerves, or other organs (like the stomach, intestines, bladder, ureters). You might need additional procedures to fix these injuries.
Temporary difficulty emptying the bladder
Blood clots in the veins of the legs or lungs
Injury to the nerves in the legs from the positioning or the nerves of the abdominal wall causing pain in the future
Problems from the anesthesia