Abdominal exploration

Exploratory surgery; Laparotomy; Exploratory laparotomy

Abdominal exploration is surgery to look at the organs and structures in your belly area (abdomen). This includes your:

Appendix
Bladder
Gallbladder
Intestines
Kidney and ureters
Liver
Pancreas
Spleen
Stomach
Uterus, fallopian tubes, and ovaries (in women)

Surgery that opens the abdomen is called a laparotomy.

Description

Exploratory laparotomy is done while you are under general anesthesia. This means you are asleep and feel no pain.

Your surgeon makes a cut into the abdomen and examines the abdominal organs. The size and location of the surgical cut depend on the specific health concern.

A biopsy can be taken during the procedure.

Laparoscopy describes a procedure that is performed with a tiny camera placed inside the abdomen. If possible, laparoscopy will be done instead of laparotomy.

Why the Procedure Is Performed

Your health care provider may recommend a laparotomy if imaging tests of the abdomen, such as x-rays and CT scans, have not provided an accurate diagnosis.

Exploratory laparotomy may be used to help diagnose and treat many health conditions, including:

Cancer of the ovary, colon, pancreas, liver
Cancer
Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.

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Endometriosis
Endometriosis
Endometriosis occurs when cells from the lining of your womb (uterus) grow in other areas of your body. This can cause pain, heavy vaginal bleeding,...
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Gallstones
Gallstones
Gallstones are hard deposits that form inside the gallbladder. These may be as small as a grain of sand or as large as a golf ball.
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Hole in the intestine (intestinal perforation)
Acute appendicitis
Acute appendicitis
Appendicitis is a condition in which your appendix gets inflamed. The appendix is a small pouch attached to the end of the large intestine.
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Diverticulitis
Diverticulitis
Diverticula are small, bulging sacs or pouches that form on the inner wall of the intestine. Diverticulitis occurs when these pouches become inflame...
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Acute or chronic pancreatitis
Acute
Acute pancreatitis is sudden swelling and inflammation of the pancreas.
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Chronic pancreatitis
Pancreatitis is swelling of the pancreas. Chronic pancreatitis is present when this problem does not heal or recurs and does not improve, gets worse...
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Liver abscess
Liver abscess
Pyogenic liver abscess is a pus-filled pocket of fluid within the liver. Pyogenic means "with pus".
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Pockets of infection (retroperitoneal abscess, abdominal abscess, pelvic abscess)
Abdominal abscess
An abdominal abscess is a pocket of infected fluid and pus located inside the belly (abdominal cavity). This type of abscess can be located near or ...
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Pregnancy outside of the uterus (ectopic pregnancy)
Ectopic pregnancy
An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus).
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Scar tissue in the abdomen (adhesions)
Adhesions
Adhesions are bands of scar-like tissue that form between two surfaces inside the body and cause them to stick together.
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Risks

Risks of anesthesia and surgery in general include:

Reactions to medicines
Breathing problems
Bleeding, blood clots, infection

Risks of this surgery include:

Incisional hernia
Hernia
A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes through a hole or weak area in the strong layer of the be...
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Damage to organs in the abdomen

Before the Procedure

You will visit with your provider and have medical tests before your surgery. Your provider will:

Do a complete physical exam.
Make sure other medical conditions you may have, such as diabetes or high blood pressure, are under control.
High blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
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Perform tests to make sure that you will be able to tolerate the surgery.
If you are a smoker, you should stop smoking several weeks before your surgery. Ask your provider for help.
Stop smoking
There are many ways to quit smoking. There are also resources to help you. Family members, friends, and co-workers may be supportive. But to be su...
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Tell your surgeon or nurse if:

You are or could be pregnant
You are taking any medicines, including drugs, supplements, or herbs you bought without a prescription

During the week before your surgery:

You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
Ask your surgeon which medicines you should still take on the day of surgery.

On the day of surgery:

Follow instructions about when to stop eating and drinking.
Take the medicines your surgeon told you to take with a small sip of water.
Arrive at the hospital on time.

Outlook (Prognosis)

You should be able to start eating and drinking normally about 2 to 3 days after the surgery. How long you stay in the hospital depends on the severity of the problem. Complete recovery usually takes about 4 to 6 weeks.

Open References

References

Landmann A, Bonds M, Postier R. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 46.

Young S, Tsai S. Management of periampullary cancer. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:589-599.

Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
Pelvic adhesions - illustration
Pelvic adhesions are bands of scar-like tissue that form between two surfaces inside the body. Inflammation from infection, surgery, or trauma can cause tissues to bond to other tissues or organs.
Pelvic adhesions
illustration
Abdominal exploration - series
Presentation

<strong>Abdominal exploration - series</strong><p>The abdomen contains many vital organs the stomach, the small intestine (jejunum and ileum), the large intestine (colon), the liver, the spleen, the gallbladder, the pancreas, the uterus, the fallopian tubes, the ovaries, the kidneys, the ureters, the bladder, and many blood vessels (arteries and veins).</p>

<strong>Indication</strong><p>The surgical exploration of the abdomen, also called an exploratory laparotomy, may be recommended when there is abdominal disease from an unknown cause (to diagnose), or trauma to the abdomen (gunshot or stab-wounds, or blunt trauma). Diseases that may be discovered by exploratory laparotomy include inflammation of the appendix (acute appendicitis), inflammation of the pancreas (acute or chronic pancreatitis), pockets of infection (retroperitoneal abscess, abdominal abscess, pelvic abscess), presence of uterine tissue (endometrium) in the abdomen (endometriosis), inflammation of the Fallopian tubes (salpingitis), scar tissue in the abdomen (adhesions), cancer (of the ovary, colon, pancreas, liver), inflammation of an intestinal pocket (diverticulitis), hole in the intestine (intestinal perforation), pregnancy in the abdomen instead of uterus (ectopic pregnancy), to determine the extent of certain cancers (Hodgkin's lymphoma).</p>

<strong>Procedure</strong><p>While the patient is deep asleep and pain-free (general anesthesia), the surgeon makes an incision into the abdomen and examines the abdominal organs. Different incisions are sometimes used depending on the circumstance. Common incisions include a vertical midline incision, and right or left upper or lower quadrant transverse incisions. Tissue samples (biopsies) can be taken and diseased areas can be evaluated. When the treatment is complete, the incision is closed with either sutures or skin staples.</p>

<strong>Aftercare</strong><p>The outcome from surgery varies with the disease process, as does the course and duration of recovery. Exploratory laparotomy is most commonly performed for trauma, severe abdominal pain of unknown cause, intestinal obstruction, inflammatory diseases like appendicitis and diverticulitis, and cancer of any of the abdominal organs.</p>

Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
Pelvic adhesions - illustration
Pelvic adhesions are bands of scar-like tissue that form between two surfaces inside the body. Inflammation from infection, surgery, or trauma can cause tissues to bond to other tissues or organs.
Pelvic adhesions
illustration
Abdominal exploration - series
Presentation

A Closer Look

Talking to your MD

Self Care

Tests for Abdominal exploration

Review Date: 3/31/2024

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Health Library

Abdominal exploration

Description

Biopsy

Laparoscopy

Why the Procedure Is Performed

x-rays

CT scans

Cancer

Endometriosis

Gallstones

Acute appendicitis

Diverticulitis

Acute

Chronic pancreatitis

Liver abscess

Abdominal abscess

Ectopic pregnancy

Adhesions

Risks

Hernia

Before the Procedure

High blood pressure

Stop smoking