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In trauma exploratory laparotomy, any immediate, life-threatening bleeding is first identified and controlled. In these cases, sponges are often packed in the spaces around the liver and the spleen to slow bleeding until a source can be found. This allows the surgeon to focus on one area at a time by removing the sponges from that quadrant. [1]
The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen ().Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (see stomach, kidney, liver, etc.) Diseases affecting the abdominal cavity are dealt with generally under their own names.
Surgical residents who wish to focus on this area of surgery gain additional laparoscopic surgery training during one or two years of fellowship after completing their basic surgical residency. In OB-GYN residency programs, the average laparoscopy-to-laparotomy quotient (LPQ) is 0.55. [10]
In diagnostic laparotomy (most often referred to as an exploratory laparotomy and abbreviated ex-lap), the nature of the disease is unknown, and laparotomy is deemed the best way to identify the cause. In therapeutic laparotomy, a cause has been identified (e.g. colon cancer) and the operation is required for its therapy.
The most common use of exploratory surgery in humans is in the abdomen, a laparotomy. If a camera is used, it's called a laparoscopy . A laparotomy can be used to diagnose cancer , endometriosis , gallstones , gastrointestinal perforation , appendicitis , diverticulitis , liver abscess , ectopic pregnancy , and other conditions involving ...
The first step after removing the temporary closure device is to ensure that all abdominal packs are removed. Typically the number of packs has been documented in the initial laparotomy; however, an abdominal radiograph should be taken prior to definitive closure of the fascia to ensure that no retained sponges are left in the abdomen.
The blood accumulates in the space between the inner lining of the abdominal wall and the internal abdominal organs. Hemoperitoneum is generally classified as a surgical emergency; in most cases, urgent laparotomy is needed to identify and control the source of the bleeding. In selected cases, careful observation may be permissible.
Recovery may be slightly faster after laparoscopic surgery, although the laparoscopic procedure itself is more expensive and resource-intensive than open surgery and generally takes longer. Advanced pelvic sepsis occasionally requires a lower midline laparotomy. Complicated (perforated) appendicitis should undergo prompt surgical intervention. [1]