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Surgical preparation of a wide area of the abdomen is performed to allow an adequate surgical incision, routinely from xiphisternum to pubis, to be performed. It is essential that thorough patient evaluation is conducted prior to induction of general anaesthesia and that appropriate intravenous fluid therapy has been provided to achieve timely correction of dehydration or hypovolaemia. Unless specifically contraindicated, e.g., protracted vomiting, water should be freely available until the time of premedication. In patients that are young a minimum period of starvation of 6 hours is adequate. Other than in emergency situations the patient should be starved overnight prior to the procedure. Information should have been gained preoperatively through thorough investigations, therefore allowing formulation of a provisional surgical plan.Īppropriate client communication regarding the reason for exploratory laparotomy, implications of differential diagnoses and postoperative care is essential before proceeding. It is however essential that a thorough history taking, patient evaluation, blood work and appropriate diagnostic imaging have been performed prior to surgery. The surgery is exploratory and therefore it may not be possible to predict further management preoperatively.

An exploratory laparotomy may be necessary for therapeutic purposes if there is intra-abdominal haemorrhage, visceral obstruction, a mass lesion, unusual accumulations of fluid or peritoneal contamination. Coeliotomy is the more correct term to refer to a midline approach however, both terms have come to be used interchangeably.Īn exploratory laparotomy is indicated for diagnostic purposes when direct inspection or palpation of abdominal contents is required to achieve a diagnosis or samples collected at laparotomy are required for cytology, histopathology or culture. Strictly speaking, laparotomy refers to an abdominal incision through the flank. Books & VINcyclopedia of Diseases (Formerly Associate)Įxploratory laparotomy is the exploration of the peritoneal cavity, routinely through a ventral midline incision.VINcyclopedia of Diseases (Formerly Associate).