Abdominal surgery

The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen. Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (see stomach, kidney, liver, etc.) Diseases affecting the abdominal cavity are dealt with generally under their own names (e.g. appendicitis).

Types

The three most common abdominal surgeries are described below.

• Exploratory laparotomy -- This refers to the opening of the abdominal cavity for direct examination of its contents, for example, to locate a source of bleeding or trauma. It may or may not be followed by repair or removal of the primary problem.
• Appendectomy -- Surgical opening of the abdominal cavity and removal of the appendix. Typically performed as definitive treatment for appendicitis, although sometimes the appendix is prophylactically removed incidental to another abdominal procedure.
• Laparoscopy -- A minimally invasive approach to abdominal surgery where rigid tubes are inserted through small incisions into the abdominal cavity. The tubes allow introduction of a small camera, surgical instruments, and gases into the cavity for direct or indirect visualization and treatment of the abdomen. 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. The laparoscopic method speeds recovery time and reduces blood loss and infection as compared to the traditional "open" cholecystectomy.

Complications

Complications of abdominal surgery include

• bleeding,
• infection,
• post-surgical adhesions
• shock, and
• ileus, or more commonly Paralytic ileus (short-term paralysis of the bowel)

Sterile technique, aseptic post-operative care, antibiotics, and vigilant post-operative monitoring greatly reduce the risk of these complications. Planned surgery performed under sterile conditions is much less risky than that performed under emergency or unsterile conditions. The contents of the bowel are unsterile, and thus leakage of bowel contents, as from trauma, substantially increases the risk of infection.

See also

• Abdominoplasty
• ASA physical status classification system or perioperative physical fitness
• Diabetes
• General Surgery
• Perioperative mortality

References