More invasive than laparoscopy, laparotomy is a surgical operation which allows direct access to the organs of the belly.
Laparotomy is an operation which consists in opening the abdomen of the pubis to the sternum to allow the surgeon to access the organs. The incision can be done in different ways. It is carried out when a laparoscopy, which uses a camera, does not allow you to see the abdomen well. What is his interest? His risks? How to take care of your scar? The answers with our visceral surgeon.
What difference with a laparoscopy?
“”Laparotomy is a surgical intervention which consists in opening the belly with a more or less large incision while laparoscopy, also called laparoscopy, is based on several small incisions which allow you to introduce a camera in the belly after having inflated it with carbon dioxide “explains Dr. Aurélien Venara.
Indications: When to do it?
The laparotomy is indicated in different situations:
- When patients have been operated many times,
- When laparoscopy does not allow access to the desired part of the abdomen,
- When we cannot do the intervention properly by laparoscopy
- When the tumors are too large to be able to go out by a small orifice.
“”Nevertheless, laparotomy is down diet and surgeons promote laparoscopy when possible because The suites are better in terms of recovery. In other words, if we decide to make a laparotomy it is not a mistake, it is because we have no choice, nuances the visceral surgeon. Indeed, laparotomy is only the way in which the interior of the abdomen is discussed. This should not change the gesture that is made on the abdominal organs“, Observe our interlocutor.
The incision can be done in different ways.
- Median laparotomy is to open the abdomen between pubis and sternum.
- Pfannestiel laparotomy is to open the abdomen in the lower abdomen horizontally, where the first pubic hair are.
- Horizontal laparotomy is widely practiced in women who give birth by cesarean.
What are the complications?
“”The main risk of complications specific to laparotomy is that of evidence because the muscles or the skin do not heal very well. As a result, there is like a hernia that forms on the scar. Likewise, the greater the opening, the more there is a risk of abscess. The other risks are inherent in the surgical technique, it is variable depending on the organ which is operated “continues the specialist.
What are the follow -up?
The operating suites are variable depending on the organ which is operated. After a laparotomy, the functioning of the intestine may be altered: it inflates a little and the gases no longer come out, it is the equivalent of an occlusion but functional. “”In general, this recovers after a few days. Today, laparotomy is much better tolerated than a few years ago since we have made many progress in the management of pain “welcomes Dr. Aurélien Venara.
Convalescence after a laparotomy
The duration of convalescence varies depending on the body which is operated. “”If you remove the gallbladder, the patient can find his home after 3 or 4 days And resume activities in an almost normal way. On the other hand, the operation of a peritonitis with a perforation of the colon requires that the patient remains in the hospital during 5 to 15 days, he will therefore take more time to recover his usual functions“, wishes to specify the visceral surgeon.
Scar
After 48 to 72 hours, the scar is left in the open air and you can take a shower without any problem
The laparotomy scar does not necessarily require any particular care when carried out in a context which presents little risk of infection. In general, points are made under the skin so there is no threads to be removed. After 48 to 72 hours, the scar is left in the open air and you can take a shower without any problems. “”On the other hand, if an infection has been detected, whatever the context, there may be dressings requiring the care of a nurse at home. In general, moisturizing creams can be recommended, but you should know that it is especially the massage of the scar twice a day which is important to soften the tissues and break the adhesions“warns the specialist.
Can we play sports afterwards?
After a laparotomy, you should not do sports or carry heavy loads for one to two months. Some practitioners recommend wearing a compression belt. You can resume its activities of everyday life but without making an effort.
Thank you to Dr Aurélien Venara, visceral surgeon at the Angers University Hospital.
