Laparotomy

Laparotomy is an open operation to be carried out through the opening of the abdominal wall.

The most common gynecological operations performed by open surgery, removal of the uterus because of large Fibroids in the uterus or because there is cancer in the abdomen.

In some cases it is not known with certainty in advance whether a tumor or ovarian cyst is benign or not. In these cases, a sample of the tumor during surgery and examine which type is involved and what is to be done.

Before surgery, the doctor will discuss what is best to do in your case and inform about what you plan to do or remove. If that pop up unexpected findings during surgery, it may be necessary to extend the procedure.

The surgery

The operation takes place in anesthetic. The incision is most often across the bottom of the abdomen (“bikini cut”). In some cases, a selected longitudinal section in the median plane and from the navel down to the pubic bone. Where the cut down, is dependent on the operation to be performed, the uterus or systems / tumor size, previous operations, known adhesions, obesity, etc. In connection with the operation a catheter placed in the bladder, so that it is maintained empty during the procedure.

By benign cysts and tumors of the ovary, it is often sufficient to remove only a portion of one ovary. Although an entire ovary is removed, there will be no changes in the hormones, or menstruation, if the other ovary is normal. The residual ovarian will take over the control, and there will continue to be monthly ovulation and menstruation.

By surgery for cancer depends on the engagement of where the cancer is located and how widespread it is.

In very difficult conditions, it may occasionally be necessary to lay the intestine above one story.

How do I prepare?

By following the directions on the standard and possible. Intestinal emptying as staff extradite their appraisal. In addition, cessation of smoking and alcohol intake associated with fewer complications and faster healing.

What can laparotomy show?

Basically is made laparotomy when you know the problem. That is, removing a large uterus that bothers because of fibroids, or removing the uterus, ovaries and fallopian tubes because of cancer.

How dangerous is laparotomy?

Minor complications occur in about 10% after removal of the uterus. It is usually a hematoma or infection in the wound. Major bleeding during or after surgery occurs in 1-2% and may require blood transfusions or re-operation.

In rare cases can cause damage to the ureter, urinary bladder or bowel. The risk is highest if there are adhesions.

Blood clots can also occur, although given preventive medicine.

Any anesthetic also entails a certain risk. The risk of complications is increased by smoking, obesity and some chronic diseases.

To reduce the risk of infection in the wound we can. Get preventive antibiotics. In most cases varicose veins and anticoagulant treatment. To prevent blood clots, it is also important to get out of bed as soon as possible.

After surgery

We need real analgesic treatment the first week and possibly. Medication for nausea in the first days. In most cases, common OTC drugs sufficient, but there may be need for morphine formulations in the first day. The pain medications must be taken at fixed times to prevent pain and good pain management makes it easier to move around. It is important to prevent blood clot and to get stomach started. It takes more than dedication to if the first is given when there is pain. After laparotomy goes bowel function temporarily halt and stomach may feel bloated and distended. Laxatives can be given until bowel function is in progress, but fluid intake and physical activity reduces the hassle.

Hospital stay usually lasts 1-3 days and sick leave 1-4 weeks depending on the age and type of operation.

If you after discharge will have major bleeding from the wound or vagina, fever or severe pain you can contact the doctor on duty at the department. Sexual intercourse should be avoided as long as there is vaginal bleeding. Generally resume cohabitation and other activity when you feel ready for it. If signs of cystitis you can contact their own doctor.

All tissues removed, is microscopically examined. If further treatment is necessary, you will be contacted.