laparotomy n : surgical incision into the abdominal wall; often done to examine abdominal organs
A laparotomy is a surgical procedure involving an incision through the abdominal wall to gain access into the abdominal cavity. It is also known as coeliotomy.
TerminologyIn 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. peptic ulcer, colon cancer) and laparotomy is required for its therapy.
Usually, only exploratory laparotomy is referred to as a surgical operation by itself; and when a specific operation is already planned, laparotomy is considered merely the first step of the procedure.
Spaces accessedDepending on incision placement, it may give access to any abdominal organ or space, and is the first step in any major diagnostic or therapeutic surgical procedure of these organs, which include:
Types of incisions
MidlineThe most common incision for laparotomy is the midline incision, a vertical incision which follows the linea alba.
Midline incisions are particularly favoured in diagnostic laparotomy, as they allow wide access to most of the abdominal cavity.
OtherOther common laparotomy incisions include:
- the Davis or Rockey-Davis "muscle-splitting" right lower quadrant incision for appendectomy;
- the Pfannenstiel incision, a transverse incision below the umbilicus and just above the pubic symphysis. In the classic Pfannenstiel incision, the skin and subcutaneous tissue are incised transversally, but the linea alba is opened vertically. It is the incision of choice for Cesarean section and for abdominal hysterectomy for benign disease. A variation of this incision is the Maylard incision in which the rectus abdominis muscles are sectioned transversally to permit wider access to the pelvis.
Related proceduresA related procedure is laparoscopy, where cameras and other instruments are inserted into the peritoneal cavity via small holes in the abdomen. For example, an appendectomy can be done either by a laparotomy or by a laparoscopic approach.
laparotomy in German: Laparotomie
laparotomy in French: Laparotomie
laparotomy in Italian: Laparotomia
laparotomy in Norwegian: Laparotomi
laparotomy in Polish: Laparotomia
laparotomy in Portuguese: Laparotomia