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A 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. There is no evidence of short-term or long-term advantages for peritoneal closure during laparotomy. [15]
The abdomen is inflated with carbon dioxide gas to facilitate visualization and, often, a small video camera is used to show the procedure on a monitor in the operating room. The surgeon manipulates instruments within the abdominal cavity to perform procedures such as cholecystectomy ( gallbladder removal), the most common laparoscopic procedure.
After opening the fascia, the abdominal cavity, or peritoneum, is entered. The surgeon then looks for evidence of injury, infection, or disease. In trauma exploratory laparotomy, any immediate, life-threatening bleeding is first identified and controlled.
The first step after removing the temporary closure device is to ensure that all abdominal packs are removed. Typically the number of packs has been documented in the initial laparotomy; however, an abdominal radiograph should be taken prior to definitive closure of the fascia to ensure that no retained sponges are left in the abdomen.
No incision provides wider pelvic exposure, and is relatively painless compared to midline incisions. Result is the most pleasing cosmetic result of any abdominal incision. Kocher's incision – An oblique incision made in the right upper quadrant of the abdomen, classically used for open cholecystectomy. Named after Emil Theodor Kocher.
During open surgery the surgeon exposes the peritoneal cavity to the ambient air. Exposure to ambient air results in evaporation and cooling. Current studies have shown that the use of surgical humidification during open abdominal surgery (laparotomy) have warmer core body temperatures and reduced risk of operative hypothermia.
Laparoscopy (from Ancient Greek λαπάρα (lapára) 'flank, side' and σκοπέω (skopéō) 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera.
Traditionally, colectomy is performed via an abdominal incision, a technique known as laparotomy. Minimally invasive colectomy using laparoscopy is a well-established procedure in many medical centers. [5] [6] Robot-assisted colectomy is growing in scope of indications and popularity. [7]