laparotomie

Laparotomie, or laparotomy, is a surgical procedure that involves a large incision through the abdominal wall to access the peritoneal cavity. Performed under general anesthesia, it serves diagnostic and therapeutic purposes, enabling direct inspection of abdominal organs and execution of interventions when less invasive methods are insufficient.

A midline laparotomy is the most common approach, a vertical incision along the linea alba that provides wide exposure. Other incisions include subcostal (Kocher) for the upper abdomen, transverse, and, in extensive disease, thoracoabdominal.

Indications include acute abdomen requiring diagnosis or treatment, traumatic intra-abdominal injury, perforation, obstruction, infections, and tumor resection or staging.

During the operation, the surgeon explores the cavity, controls bleeding, resects or repairs tissues, and may place drains. Postoperative care focuses on pain control, infection prevention, and mobilization. Hospital stay varies with the underlying condition and extent of surgery.

Complications include infection, bleeding, organ injury, adhesions, and incisional hernia.

Laparotomy is increasingly contrasted with laparoscopy, a minimally invasive alternative, but remains essential when extensive exposure or definitive reconstruction is required.