Laparotomy surgery in Turkey: Prices, procedures and complications 2024

Risks of laparotomy surgery

Laparotomy is a surgical procedure used to treat a variety of abdominal conditions. However, like all surgical procedures, it carries risks. These may include:

• Bleeding: which may require a blood transfusion.
• Infection: of the surgical wound.
• Anesthesia-related complications: allergies, breathing problems, etc.
• Accidental damage to nearby organs.
• Adhesions: may cause chronic abdominal pain or bowel obstruction.

Laparotomy: why and when?

Laparotomy, a major surgical procedure involving the opening of the abdominal cavity, is indicated in certain specific situations where laparoscopy (minimally invasive surgery) is not appropriate. It is generally indicated for:

• Severe abdominal emergencies: massive internal bleeding, organ perforation, open abdominal trauma, etc. In these situations, rapid action and direct access to all organs are essential.
• Large or complex tumors: Some tumors, especially those that have invaded multiple organs or structures, require extensive surgical exploration.
• Significant abdominal adhesions: Postoperative adhesions or inflammation may make laparoscopy impossible.
• Morbid obesity: For certain bariatric procedures, laparotomy may be technically easier.
• Inadequate equipment: In some facilities, laparoscopy is not available or equipment is limited.

The choice between laparotomy and laparoscopy is an important medical decision that must be made in conjunction with your surgeon. Your surgeon will consider your overall health, the type of surgery to be performed, and technical limitations to recommend the best solution for your situation.

Exploratory laparotomy: when medical uncertainty requires surgery

If abdominal pain persists and imaging tests fail to identify the cause, an exploratory laparotomy may be necessary. This surgical procedure allows the doctor to visually examine the inside of the abdomen to detect any abnormalities and make an accurate diagnosis.

What is involved?

The surgeon will make an incision in the abdominal wall, the size and location of which will vary depending on the area being examined. The most common incisions are the median laparotomy (vertical) and the Pfannenstiel laparotomy (horizontal).

Why use them?

The absence of a diagnosis, combined with worsening symptoms or the risk of complications, sometimes justifies the use of an exploratory laparotomy. Although invasive, this procedure is essential to resolve any doubts and ensure appropriate treatment. It helps avoid potentially serious complications and ensures optimal patient care.

Laparotomy incision types

Open surgery requires a specific incision for each procedure. While the median, horizontal, and subcostal incisions are the most common, other more specific types of incisions are used depending on the organ being operated on:

• Pararectal: Located near the rectus abdominis muscle, this incision provides direct access to certain pelvic organs.
• McBurney: This oblique incision, located in the right iliac fossa, is used specifically for appendectomies.
• Kocher: Located below the right costal margin, this oblique incision facilitates access to the gallbladder during cholecystectomy.

Preparation for laparotomy

The patient must fast before the surgery: no solid food or clear liquids in the hours preceding the surgery.

A shower with an antiseptic product is also recommended to reduce the risk of infection.

To promote healing, it is important to stop smoking at least two months before surgery and to limit alcohol consumption in the days leading up to surgery.

These simple precautions will optimize surgical conditions and promote a rapid recovery.

Operational phase

The procedure for laparotomy varies depending on the type of surgery, but generally follows a precise protocol.

After general (or sometimes local) anesthesia, the surgeon makes an incision in the abdomen to gain access to the organs. After surgery, the wound is carefully closed, often with stitches or staples. A drain may be placed to evacuate any fluids.

In certain complex cases, a laparostomy may be necessary, in which the wound is left open temporarily.

The duration of the surgery depends on its complexity and can range from a few tens of minutes to several hours.

Hospitalization and post-operative recovery

The length of hospital stay and recovery time after laparotomy varies depending on the complexity of the surgery and the patient's overall health.

The first few days after surgery are often marked by extreme fatigue and digestive problems. Painkillers are prescribed to relieve the pain.

To prevent complications, the scar is carefully monitored and dressings are changed regularly. Drainages may be used to remove excess fluid.

A follow-up visit is scheduled approximately one month after discharge to assess the progress of scarring.

Recovery time after laparotomy is generally longer than after laparoscopy. Post-operative pain is more severe and it may take several weeks to resume normal activities.

Tips for a good recovery

It's important to follow your doctor's instructions exactly, including taking your medicine, monitoring your temperature, and changing your bandages regularly. Get plenty of rest and avoid strenuous activity for the first few weeks.

Eat a well-balanced, high-fiber diet to promote healing.

Finally, resume physical activity gradually in consultation with your doctor, especially before returning to sports.