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Medical Disability Advisor  >  Laparotomy

Laparotomy


Related Terms


  • Exploratory Abdominal Surgery
  • Exploratory Laparotomy

Specialists


  • General Surgeon

Comorbid Conditions


  • Emphysema
  • Heart disease
  • Obesity

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Factors Influencing Duration


Recovery after laparotomy is determined by the age and general health of the individual, findings at the time of the procedure, and final diagnosis.

Duration Trends from Reference Data


DURATION TRENDS
 ICD-9-CM: 54.1, 54.11  
CasesMeanMinMaxNo Lost TimeOver 6 Months
3074101410.3%0%
 
  
 
Percentile:5th25thMedian75th95th
Days:824405589
 
  
 

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes


ICD-9-CM:
54.1 - Laparotomy
54.11 - Laparotomy, Exploratory
54.12 - Reopening of Recent Laparotomy Site; Reopening of Recent Laparotomy Site for: Control of Hemorrhage, Exploration, Incision of Hematoma
54.19 - Laparotomy, Other; Drainage of Intraperitoneal Abscess or Hematoma

Definition


A laparotomy is a surgical incision into the abdomen in order to view its internal organs including the stomach, small and large intestine, kidneys, liver, pancreas, gallbladder, and parts of the female reproductive system. The procedure is used for exploratory purposes, to take samples of abdominal tumors for cancer staging, to make or confirm a diagnosis, and to repair internal organs damaged due to disease or trauma.

Although a laparotomy is a common procedure, its use has declined in recent years due to improvements in noninvasive diagnostic procedures such as medical imaging and sonography.

Source: Medical Disability Advisor



Reason for Procedure


A laparotomy is frequently performed as an exploratory procedure to assist in determining a cause of abdominal pain. Other reasons for laparotomy include making an accurate identification and/or removal of malignant or benign growths (neoplasms), identifying an ectopic pregnancy (a fertilized egg that is trapped in the fallopian tube), correcting twisted intestines (volvulus), taking samples (biopsies) of abdominal tissue or tumors in order to determine the stage of a cancer, draining infection, and stopping bleeding.

A laparotomy is performed when internal organs such as the appendix, intestines, esophagus, stomach, colon, or gallbladder are torn apart (perforated) due to disease or trauma.

Source: Medical Disability Advisor



How Procedure is Performed


The individual is given a general anesthesia. An incision is made in the lower abdominal area. Incisions can be midline between the breastbone (sternum) and lower abdomen (pubis) or transverse across the lower part of the abdomen, depending on the suspected condition or area of trauma. However, in the individual with unclear pathology or diffuse symptoms, a midline incision is used for complete abdominal exploration.

The incision reaches down through the skin and muscle layers and is spread open so the abdominal cavity can be directly visualized. After the source of the problem is located and corrected using standard surgical procedures, the incision is closed with surgical thread (suture) or metal staples. The problem may not be able to be corrected during the laparotomy, and a subsequent surgery may be necessary. If the stomach or intestines are affected, the individual may have a rubber or plastic tube inserted through the nose and esophagus into the stomach to drain the contents while the affected area heals.

Source: Medical Disability Advisor



Prognosis


The outcome following a laparotomy depends on the underlying reason for surgery, the individual's general health condition, extent of tissue damage, age, obesity, loss of blood due to trauma and any other disorders such as emphysema or heart disease. Complete recovery typically takes approximately 4 weeks.

Source: Medical Disability Advisor



Complications


Complications include allergy or abnormal responses to anesthesia, unintentional perforation of an organ, excessive bleeding, wound or systemic infection, or internal scarring and chronic pain. If peritonitis is present and not treated rapidly, it can lead to multisystem failure and death. Delayed laparotomy in the instance of trauma can lead to excessive or fatal bleeding.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)


No restrictions or special accommodations are necessary for healthy individuals resuming light to medium work. Resumption of heavy work and lifting should be delayed until healing is complete and medical clearance received.

Source: Medical Disability Advisor



General References


Marx, J. A., et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th ed. Philadelphia: Elsevier, Inc., 2004.

Source: Medical Disability Advisor






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