Minimally Invasive Surgery & Procedures Laparotomy

What is a laparotomy?

A laparotomy is an operation where a cut has been made in your tummy. It may be ‘up and down’ from your tummy button to bikini line, or ‘across’ your tummy. This allows different operations to be performed, which will be fully discussed with you beforehand.

What are the benefits of having a laparotomy?

This operation allows Dr McMurray to look inside your tummy to find out what may be causing your problems and if necessary, carry out the surgery to treat it. Dr McMurray would have discussed this with you at your outpatient consultations.

What are the risks, consequences and alternatives associated with having a laparotomy?

Most operations are straightforward; however as with any surgical procedure there is a small chance of side-effects or complications such as:

  • Excessive bleeding may occur occasionally, either during the operation or afterwards. You may require a blood transfusion and very rarely a second operation may be necessary to stop the bleeding.
  • There is a small risk you may develop infection that requires antibiotics.
  • There is a very rare risk of damage to the ureters (the tubes connecting the kidneys to the bladder) and the bladder.
  • Other rare risks include bowel injury and anaesthetic complications and clots in veins (thrombosis) and lungs in the days following surgery. The risk of thrombosis is minimised by giving injections of Heparin under the skin during your hospital stay. This thins the blood slightly without significantly increasing the risk of bleeding.

If you are worried or would like further details about these risks, please speak to Dr McMurray.

Getting ready for the operation

You will be provided with information about how to prepare for your operation, either by staff on the ward or during a clinic appointment. For a time before certain types of anaesthetic you will need to stop eating, drinking and chewing gum.

If you have any questions please contact the hospital – telephone number on your admission letter.

You will be asked to have a bath or shower before coming into hospital (if possible).

On admission

You will be asked to sign a consent form to say that you understand what you have come into hospital for and what the operation involves. Please feel free to ask any questions you may have. You will be given a theatre gown to wear. A porter will walk you to the anaesthetic room.

What sort of anaesthetic will I have?

Most women will have a general anaesthetic, which means you will be asleep throughout. The anaesthetist will visit you before your operation and discuss the anaesthetic with you.

What should I expect after the operation?

When the operation is over, you will have your pulse, blood pressure, breathing and wounds checked regularly by a nurse. It is usual to feel drowsy for several hours. You will be given oxygen through a face mask until you are more awake. Anaesthetics can sometimes make people feel sick. The nurse may offer you an injection if the sick feeling does not go away, this will help to settle it.

Pain relief

You may have some pain following your operation. Painkillers may be given through your drip, by injection or suppositories. In addition you may also be offered regional anaesthesia to help with pain. Once you are eating and drinking as normal, tablets will be given. If you experience pain it is important to tell the nurses who can give you painkillers to help.

Eating and drinking

You will have a drip for the first 24 hours to replace fluids from not eating and drinking. You may be able to take sips of water. The next day, you will be advised when you will be able to have hot drinks and a small meal. You may not have much of an appetite for a few days.

Wound care

You may have a dressing on your tummy, which will be removed on the second day after your operation. Before you go home, any stitches, staples or clips will have been removed from your wound. Any dissolvable stitches do not have to be removed. Occasionally a small plastic tube (called a drain) is placed in the tummy if the operation has been particularly difficult. This usually stays in place for 24 – 48 hours. You may bleed after the operation, similar to a period – which will settle to a brown discharge and you will need to wear a sanitary towel (not tampons).

Mobilising

It is important to get out of bed and take a short walk the day after your operation. This helps reduce the risk of blood clots forming in the veins and lungs. It will also help to get rid of ‘trapped wind’.

You will be given an exercise sheet to follow that includes deep breathing and leg exercises.

Bathing and showering

A nurse will help you to have a bed bath the day after your operation. You may have a shower on the second day after your operation when your wound dressing has been removed. A daily shower/bath is advisable to aid healing and assistance will be given if needed.

Bladder and bowels

You may have a catheter (tube in the bladder) in place to drain the urine away. This is usually removed the following day. Your bowel habits should return to normal after a few days. Laxatives and suppositories may be needed to help you to avoid straining. Please let the nurse know if you are having difficulties.

Going home

As soon as you no longer need medical or nursing care (usually 2 – 7 days depending on type of operation and your recovery), you will be able to go home to continue your recovery.

DISCHARGE INFORMATION AND AT HOME ADVICE

Will I take some medication home with me?

If you began any medication while you were in hospital and you need to take it at home, it will be given to you before you are discharged. Paracetamol can also be taken if required – do not exceed the stated dose.

Your wound may feel sore/numb or you may experience ‘pins and needles’ for some time after.

Stitches/dressings

If the stitches are not removed on the ward, arrangements will be made for this. Any bruising should soon disappear.

Contact your GP or call us at the clinic for advice if you experience any of the following:

  • severe pain or temperature.
  • your wound becomes very sore, hot to touch, red or oozing.
  • your vaginal bleeding increases, or you notice an odour.

Tiredness

You may feel tired when at home – do as much as your body tells you. You may experience good days and bad days – this is normal after your operation.

Sexual intercourse

When you and your partner find it appropriate to resume sexual intercourse you may do so, approximately 8 weeks after your operation.

Returning to normal activities

When at home for the first few weeks, you are advised to do gentle housework only, eg. dusting and washing-up. Cooking and ironing will be suitable for short periods of time. Avoid any heavy lifting, eg. carrying shopping, until after your 8 week check-up. You may continue your hospital exercises at home. Walking is a good exercise from the beginning. Once you have had your 8 week check-up, other sports can be resumed.

Driving

The usual recommended time is 4 – 6 weeks after your operation. Do not drive until you can wear a seat belt comfortably and feel able to perform an emergency stop. Your insurance company may refuse to meet a claim if they feel you have driven too soon. It is also advisable to contact your insurance company with regards to cover following a general anaesthetic.

Time off work

You will be ready to start work within 6 – 12 weeks. This will depend on your job.

Follow-up appointment

Dr McMurray will wish to see you in the outpatient clinic. If so, you will be sent an appointment for approximately 6-8 weeks’ time.