Exploratory Laparotomy: How to Prepare

An exploratory laparotomy—also called an "ex lap" or celiotomy—is a major surgery used to examine the organs and tissues within a patient's abdomen and pelvis. Since the surgery requires that a large incision be made down the abdomen, patients need to stay in the hospital for several days afterward.

If the laparotomy is emergent—for example, for internal bleeding from a car accident or for a perforated bowel—preparatory strategies are focused on the medical team administering life-saving therapies (e.g., blood products or fluids).

If the laparotomy is scheduled—for example, to diagnose suspected ovarian cancer or to evaluate chronic abdominal pain—then careful preparation, including stopping smoking and certain medications prior to surgery, is important for optimizing the patient's healing and recovery process.

Location

An exploratory laparotomy is performed under general anesthesia in a hospital. On the day of your surgery (if scheduled), you will arrive at the hospital and be taken to a small pre-operative room with a hospital bed and a curtain.

Here, you can expect the following:

• You will change into a hospital gown.
• A nurse will record your vital signs and place an IV into your arm or hand.
• Your surgeon and the anesthesiologist will come to greet you.
• You may need to sign one or more consent forms, which addresses potential risks associated with the surgery.

Once your surgical team is ready (which often includes a scrub nurse and surgical assistant, in addition to your surgeon and anesthesiologist), you will be taken into the operating room.

In the operating room, you will lay down on an operating table where you will be attached to various monitoring devices. Your anesthesiologist will then administer medications to put you to sleep. You will not experience any pain or remember anything during the surgery.

What to Wear

On the day of your surgery, your surgeon will advise the following:

• Shower and arrive at the hospital wearing comfortable, loose-fitting clothes.
• Leave jewelry and other valuables at home.
• Avoid wearing nail polish and contact lenses.
• Avoid wearing skin products including deodorant, perfume, body lotion, and makeup.

Food and Drink

Your surgeon will likely advise you to stop eating after midnight on the eve of your surgery. The purpose of this is mainly related to intubation and preventing food or liquid from getting into your lungs and causing pneumonia.

Your surgeon may give you the OK to drink clear liquids up until two hours before your surgery. Be sure to discuss specific instructions with your surgeon, as they may vary.

Examples of clear liquids would include:

• Water
• Clear juices like apple, white grape, or white cranberry juice
• Black tea or coffee (no milk or creamer)
• Clear broth
• Clear sodas like ginger ale

Medications

A week or two before surgery, you will have appointments with your surgical team and with someone (usually a nurse) from the anesthesia department. At these appointments, instructions regarding surgical expectations, and preparatory and recovery processes will be reviewed. At this time, do not hesitate to ask questions or address any concerns you have.

During these appointments, your surgical team will also review your medications. To ensure a safe surgery, it's important to tell your surgeon and the anesthesia nurse all of the medications you are taking.

These may include:

• Prescription drugs
• Over-the-counter drugs
• Nutritional supplements, vitamins, and herbal products
• Recreational or street drugs

After reviewing your medication list, you will be instructed on which ones to continue and which ones to stop prior to the surgery. For example, you will likely be requested to stop medicines which may increase your risk of bleeding during surgery and/or potentially interfere with the anesthesia drugs.

What to Bring

After surgery, you can expect to stay in the hospital for around five to 10 days. The exact number of hospitals days will depend on various factors like:

• Whether the surgery is scheduled or emergent
• What the surgeons find during the operation
• If any therapeutic repairs are performed during the same operation
• Whether any post-operative complications develop like bleeding or infection

To prepare for your extended hospital stay, you should bring these items with you on the day of your surgery:

• Your insurance card
• Your driver's license
• Loose-fitting clothes to leave the hospital in
• Personal items, such as underwear, toothbrush, hairbrush, soap, glasses, and a cell phone charger
• Small items to help keep you comfortable during your recovery—these may include earplugs, sleep mask, a cozy pillow, and a packet of soft kleenex.

For patients undergoing an emergent laparotomy, loved ones may bring in the above items. These items will then be delivered to the patient once they are out of surgery (and the recovery room) and in their hospital room.

Pre-Op Lifestyle Changes

The specific pre-operative lifestyle changes advised by your surgeon will vary depending on the reason behind the operation and whether the surgery is emergent or scheduled.

For instance, your surgeon may ask you to stop smoking as soon as possible prior to surgery, preferably a week or more. Stopping smoking, even the day before, lowers your risk for surgical complications and improves wound healing and heart and lung functioning after surgery.

Likewise, optimizing certain medical conditions, such as your glucose control if you have diabetes or losing weight if you are obese, may also be requested by your surgeon to improve surgical outcomes.

A Word From Verywell

Whether you (or a loved one) are scheduled for an exploratory laparotomy, or the operation is being performed emergently, it's normal to feel a bit nervous beforehand. Try to remain calm and do not hesitate to reach out to your healthcare team with any questions or concerns.