A laparotomy begins with the administration of general anesthesia. Once the anesthesia takes effect, the skin of the abdomen is prepared with an antibacterial solution to prevent infection at the surgical site.
The surgeon will make the incision. If the pain is in the lower right abdomen over the appendix, the incision will be placed in that area.
Two of the most common incisions are the midline incision, which is a vertical incision that is placed between the pubic bone and below the sternum, and the transverse incision, which is placed horizontally. In some cases, the incision may be small at the beginning of the surgery and then enlarged as needed to complete a procedures after a diagnosis is made.
Once the incision is made, the organs and tissues will be inspected for signs of disease, infection or inflammation. Biopsies may be taken of different tissues as needed. In some cases, the abdominal cavity may be "washed," where sterile fluid is placed in the abdomen, then collected for further study.
Once the organs and tissues of the abdomen have been inspected, the laparotomy portion of the procedure is over; however, in many cases an addition procedure will be performed. For example, a laparotomy is performed to find the source of abdominal pain, and an inflamed appendix is found, an appendectomy procedure would then be combined with the laparotomy.
The incision may be closed in a variety of ways. Larger incisions are typically closed with sutures or staples, smaller ones may be closed with adhesive strips called steri-strips or surgical glue. The incision is then covered with a sterile surgical bandage. Anesthesia is stopped and a medication is given to wake the patient, who is then taken to the recovery area.