Laparotomy

This procedure is usually performed as an emergency and is undertaken under general anaesthetic when you are too unwell to undergo a laparoscopic (keyhole) procedure. It is performed when there has been a significant life threatening event inside your abdomen such as perforation of the bowel (peritonitis), dead bowel, blockage of the bowel, bleeding or trauma. The procedure can also be performed when a laparoscopic procedure is not possible. It involves making a surgical cut through the wall of the tummy in order to gain access to the organs inside and deal with the problem making you unwell.

Recovery

Laparotomy is major surgery. After the procedure you will wake up in a hospital room most likely in a higher level care bed. The enhanced recovery programme (ERP) may be followed. You will need to spend a few nights in hospital. You are typically expected to go home once you are eating and drinking, are able to manage the pain and walk unaided. It normally takes a few weeks to fully recover from a major laparotomy and return back to work but it varies from person to person and will depends on your general health and the nature of your work. You should avoid any heavy object lifting or strenuous exercise for at least 6 weeks to reduce the risk of a hernia developing.

Risks of procedure

The likelihood of some of the risks involved in bowel surgery depends on the type of the surgery performed, the disease involved and the health of the individual and have to be balanced against the risks of not performing surgery. Remember that this procedure is mainly performed in life threatening situations. The risks include complications common to all surgical procedures such as infection, bleeding, blood clots, heart problems, pneumonia, urinary retention, development of hernia and anaesthetic risks.

Complications specific to this operation include the risk of the bowel going into strike for a few days (ileus) and rare but significant risks such as leakage from a potential bowel joint, collection of fluid/pus inside the abdomen, damage to other organs inside the abdomen and a risk to your life. Some patients may experience some change in their stool consistency following removal of part of their bowel which usually improves with time. Any relevant complications will be explained to you at an individualised basis.