EXPOLATORY LAPAROTOMY A laparotomy is a large incision made into the abdomen.

Exploratory laparotomy is used to visualize and examine the structures inside of the abdominal cavity. Reasons for Procedure This procedure is done to evaluate problems in the abdomen. Problems that may need to be examined with an exploratory laparotomy include:
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A hole in the bowel wall Ectopic (outside the womb) pregnancy Endometriosis Appendicitis Damage to an organ from trauma Infection in the abdomen Cancer

Possible Complications Complications are rare, but no procedure is completely free of risk. If you are planning to have a laparotomy, your doctor will review a list of possible complications, which may include:
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Bleeding Infection Blood clots Damage to organs Hernia formation Large scars Reaction to the anesthesia

Some factors that may increase the risk of complications include:

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Previous abdominal surgery Diabetes Heart or lung disease Weak immune system Blood disorders Taking certain medicines Smoking, alcohol abuse, or drug use

Be sure to discuss these risks with your doctor before the procedure.

What to Expect

Prior to Procedure Leading up to your procedure:

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Your doctor may perform the following: o Physical exam o Blood and urine tests o Ultrasounda test that uses sound waves to visualize the inside of the body o CT scana type of x-ray that uses a computer to make pictures of the inside of the body o MRI scana test that uses magnetic waves to make pictures of the inside of the body Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like: o Anti-inflammatory drugs (eg, aspirin) o Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin) Arrange for a ride home. The night before, eat a light meal. Unless told otherwise by your doctor, do not eat or drink anything after midnight.

Anesthesia
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General anesthesia (almost always used)blocks pain and keeps you asleep through the surgery; given through an IV in your hand or arm Spinal anesthesia (used in very ill patients)the area from the chest down to the legs is numbed

Description of the Procedure The doctor will make one long incision in the skin on your abdomen. The organs will be examined for disease. The doctor may take a biopsy. If the problem is something that can be repaired or removed, it will be done at this time. The opening will be closed using staples or stitches. How Long Will It Take? About 1-4 hours How Much Will It Hurt? Anesthesia will prevent pain during the procedure. For pain and soreness after surgery, you will get medicine. Average Hospital Stay Several daysIf you have problems, you may need to stay longer. Post-procedure Care At the Hospital
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You may need to wear special socks or boots to help prevent blood clots. You may have a foley catheter for a short time to help you urinate.

You may use an incentive spirometer to help you breathe deeply.

At Home It may take several weeks for you to recover.

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Follow your doctor's instructions. The doctor will remove the sutures or staples in 7-10 days. Take proper care of the incision site. This will help to prevent an infection. Ask your doctor about when it is safe to shower, bathe, or soak in water. During the first two weeks, rest and avoid lifting. Slowly increase your activities. Begin with light chores, short walks, and some driving. Depending on your job, you may be able to return to work. To promote healing, eat a diet rich in fruits and vegetables. Try to avoid constipation by: o Eating high-fiber foods o Drinking plenty of water o Using stool softeners if needed

Call Your Doctor After you leave the hospital, contact your doctor if any of the following occurs:
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Fever or chills Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site Increasing pain or pain that does not go away Your abdomen becomes swollen or hard to the touch Diarrhea or constipation that lasts more than 3 days Bright red or dark black stools Dizziness or fainting Nausea and vomiting Cough, shortness of breath, or chest pain Pain or difficulty with urination Swelling, redness, or pain in your leg

Sore Throat Remedies and Treatments Slippery elm was once considered a conventional treatment for sore throats in North America. Up until 1960, it was listed in the United States Pharmacopeia (a compendium of drug standards). A member of the elm family, the slippery elm tree (Ulmus Rubra Muhl) grows primarily in the eastern region of North America. For sore throats, herbalists use the inner bark of the tree. The inner bark contains mucilage, a gel-like substance that swells when it is mixed with water. The mucilage is thought to reduce throat irritation and soothe sore throat.

Slippery elm is can be found in capsule form. It is a common ingredient in herbal lozenges, either on its own (made by Thayers) or combined with elderberry and zinc. Slippery elm is also found in herbal teas for sore throat, such as Throat Comfort (Yogi Teas). 2) Licorice Root Licorice root (Glycyrrhiza glabra) has a long history of use as an herbal remedy for sore throat. According to the National Center for Complementary and Alternative Medicine (NCCAM), licorice root is used for its anti-inflammatory properties and for stomach ulcers, allergies, canker sores and viral infections. A compound in licorice, glycyrrhizin, is being studied to reduce complications from hepatitis C. A study in Anesthesia & Analgesia examined the use of a licorice root gargle to prevent sore throat. Five minutes before general anesthesia, patients either gargled with a diluted licorice root solution or plain water. The patients who gargled with the licorice root solution were less likely to have a sore throat after surgery and experienced less post-operative coughing than other patients. Licorice is a common ingredient in herbal teas for sore throat, such as Throat Coat by Traditional Medicinals (which also contains slippery elm). It has a naturally sweet taste. Licorice should not be used in large amounts, as it can lead to high blood pressure, salt and water retention, low potassium levels, and can affect levels of the hormone cortisol. It should not be combined with diuretics, corticosteroids, or other medications that reduce potassium levels in the body. People with heart disease or high blood pressure should use caution when using licorice. Pregnant women should avoid licorice. 3) Marshmallow Root Marshmallow, a herb that grows in North America and Europe, has been used for centuries as a sore throat remedy. Like slippery elm, marshmallow contains mucilage, which is thought to soothe the mucus membranes in the throat. Herbalists recommend marshmallow root tea as a remedy for sore throats. It is usually made by adding one tablespoon of the dried root to a cup (8 ounces) of boiling water and steeping it, covered, for 30 to 90 minutes before straining. Herbalists usually suggest up to three cups a day for a sore throat. Consult a doctor before taking marshmallow if you have diabetes, as it may make your blood sugar too low especially when combined with diabetes medication. Marshmallow may also slow the absorption of other drugs taken at the same time. Marshmallow should not be taken by pregnant or nursing women. 4) Honeysuckle Flower A sweet-tasting herb, honeysuckle flower is one of the most commonly used sore throat remedies in traditional Chinese medicine (TCM). Honeysuckle flowers aren't as easy to find as slippery elm and marshmallow. Health food stores occasionally carry it, but it is primarily sold in Chinese herbal stores.

Practitioners of traditional Chinese medicine often recommend making honeysuckle tea by bringing one quart of water to a boil and adding one cup of honeysuckle flowers (not the leaves). Steep for at least 10 minutes, covered, and then strain. Up to four cups a day are typically recommended. 5) Lemon, Apple Cider Vinegar, Cayenne, and Honey Tea An old home remedy for sore throat is tea made with lemon, apple cider vinegar, cayenne, and honey. A typical recipe would be made by adding one teaspoon of apple cider vinegar, a tiny pinch of cayenne pepper, the juice of 1/4 lemon, and one teaspoon of honey to a cup of hot water and then stirring. Typically, up to four cups a day is suggested. Honey is also used to soothe a cough. 6) Sage There is some evidence that a throat spray made from the herb sage can help to reduce sore throat. A randomized controlled trial compared the effectiveness of a 15% sage (Salvia officinalis) throat spray to a placebo in patients with sore throat. The spray was more effective than the placebo in reducing throat pain. Symptomatic relief occurred within the first two hours after the first administration. Minor side effects, such as throat dryness or burning of mild intensity, were reported. Other Home Remedies
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Gargle and rinsing your mouth with salt water several times a day. To make a salt water gargle, dissolve one teaspoon of salt in a glass of warm water. Use sore throat lozenges to increase saliva production and lubricate the throat. Lozenges shouldnt be given to young children due to the risk of choking. Drink plenty of fluids, which keeps the throat lubricated. Some people get relief by sucking something cold, such as a popsicle, while others find warm drinks, such as warm water with honey, helpful. Get plenty of rest. Eliminate dry air, which can irritate a sore throat, by using a cold air humidifier.