A laparostomy is a surgery in which the abdomen is completely open, allowing the surgeon to have access to internal organs to diagnose and treat conditions that were not previously identified through imaging. These days, it is increasingly replaced by video laparoscopy, where instead of opening the abdominal cavity completely, small entries are opened to introduce laparoscope (small device with a video camera, which allows internal viewing) and the necessary intraments for the internal incisions.
The term “exploratory” reinforces its use to investigate something that is not sure what it is within the patient’s body, that is, to make a diagnosis. In the case of Jair Bolsonaro, the exact location of the intestinal obstruction that caused its abdominal disability. Once the exact problem is identified, the surgery can continue in order to already remedy the diagnosed problem.
What are the indications of a laparostomy?
According to the MEDSCAPE SITEUS page focused on content sharing to update doctors and other health professionals, exploratory laparotomy is often indicated in the following cases:
- Acute onset abdominal pain and clinical findings suggestive of intra-abdominal pathology requiring emergency surgery;
- Abdominal trauma with hemoperitoneum and hemodynamic instability;
- Chronic abdominal pain;
- Staging ovarian malignancy and Hodgkin’s disease;
- Obscure gastrointestinal bleeding;
- Rarer diseases.
Why perform a laparostomy in Bolsonaro?
Gastroenterologist Alexandre Carlos, assistant doctor of the Gastroenterology Department of the Hospital das Clínicas de São Paulo (HC-FMUSP), explains the reason for doctors to choose the technique: “Because of the complexity of the case, Lapathomy exploits allows the surgeon to access the cavity more easily and the time of surgery is shorter,” he says to CNN.
Laparostomy steps
As explained by the scientific article of experts Maria de Fátima Tazima, Yvone de Andrade Vicente and Takachi Moriya, published at the Symposium Fundamentals in Surgical Clinic, lapastomy is usually composed of the following steps:
- Laparotomy – surgical opening of the abdominal cavity;
- Exploration of the abdominal cavity to evaluate the extent of the pathology and to identify other possible pathologies not previously diagnosed;
- Performing surgery itself;
- Inventory or revision of the abdominal cavity to be sure that the surgery is complete and well done and to verify if not forgotten foreign bodies in the cavity (compresses, gauze, needles, etc.);
- Cavity closure.
How is recovery after a laparostomy?
Recovery after a laparostomy is higher than after a video laparoscopy, the incision takes an average of six weeks to heal. She also leaves a scar on the abdomen, which over time tends to disappear. Return to physical activity may take a few months and abdominal force tends to take two years to restore completely.
Procedure risks
Like any surgery, laparostomy is not risky. According to the American reference clinic Cleveland Clinicthe main risks of a laparostomy are:
- Unintentional injury in nearby organs.
- Excessive bleeding of injured blood vessels.
- Wound infection and delayed healing.
- Permanent numbness areas due to nerve damage.
- Hernias at the location of the incision or where the muscle was divided.
- Internal scar tissue that can interfere with their organs (abdominal adhesions).
- Intestinal obstruction due to abdominal adhesions.
See more: Bolsonaro says he should undergo surgery
This content was originally published in exploratory laparostomy: understand Jair Bolsonaro’s surgery on the CNN Brazil website.
Source: CNN Brasil
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