Laparotomy

Laparotomy is a surgery that allows the doctor to look at your reproductive organs and other structures in your abdomen. It can be used to find or treat disease. One large incision is made. It can vary in length, but it is usually from just above the navel to a couple inches above the pubic bone. You will need to have anesthesia for this surgery.

Care of Incision

• You may shower, letting the water run over the incisions. Pat dry.

• Do not apply any powders, creams, or ointments to the incision site.

• Check your incisions daily for signs of infection.

• Most of the time you will have staples in place. These help the outer edge of the incision heal. These are often removed 10-14 days after you leave the hospital.

• Your incision is held together with sutures that dissolve several places deeper in your abdomen.

Vaginal Bleeding

Vaginal bleeding is normal after this surgery. How much bleeding and for how long can vary. It may be like a light period. You may even notice some small clots. It is normal for you to notice this for up to 6 weeks after surgery.

Please contact your surgeon’s office if you are soaking more than a pad an hour or if you are concerned about the amount of bleeding.

Activities

• You may shower and shampoo. Do not soak in the bathtub or swim until cleared by your doctor.

• You can start driving again when you have stopped taking narcotic pain medicine. Also, be sure that you can control the car quickly if needed (about 2 weeks).

• Do not have sexual intercourse, douche, use tampons, or insert anything into the vagina for 6 weeks. This is called pelvic rest.

• No lifting greater than 10 pounds for 6 weeks.

• Stay home the first week and relax.

• The second and third week you may slowly increase your activity. Listen to your body for cues. Avoid fatigue and take time to rest.

• It is okay to walk up and down stairs and to walk for exercise. Do not take part in exercise that uses your stomach muscles (such as Pilates, biking, or running. Keep your exercise light.

Diet

If you feel sick to your stomach, do not eat a full meal.

• Start slowly with clear liquids such as tea, broth, or jello.

• Add solid food to your diet as your stomach feels better.

• You may want to avoid fatty foods at first and slowly add them to your diet. Fatty foods include fried foods, creams, potato chips, pizza, and large servings of gravy or butter.

How to Prevent and Treat Constipation

Preventing Constipation

You may have trouble with bowel movements after you go home.

• Drink plenty of liquids.

• Avoid caffeine drinks as they may dehydrate you.

• Being up and about is helpful.

• Narcotic pain medicine will cause constipation. Take a stool softener (Docusate Sodium/Colace) 100 mg twice daily and MiraLAX 17 gm once daily while on narcotics. This is an over-the-counter drug that can be purchased at any drug store.

Treating Constipation

If you have not had a bowel movement within 48 hours after leaving the hospital, follow these instructions:

Have you had surgery on your bowels in the last month?

• Yes – Increase MiraLAX to twice daily dosing or take milk of magnesia 2-4 tablespoonsful.

• No – Take a rectal suppository, like Dulcolax. You should have a bowel movement within 4-6 hours.

• I don’t know – Contact the Gyn/Onc RN triage line/After Hours line to review your records.

When to Call

• Severe stomach pain not relieved by pain medicine.

• Severe nausea and vomiting.

• Failure to tolerate food or liquid by mouth.

• Pain or burning with urination.

• Redness or increased tenderness around any of the incisions.

• Pus-like (yellow, green, or thick) drainage from the incision.

• If any portion of your incision opens.

• Fever (by mouth) greater than 100.4°F.

• Excessive swelling or bleeding.

• Vaginal bleeding that soaks more than one sanitary napkin in one hour.

• Constipation – no bowel movement for greater than or equal to 3 days.

• Increased shortness of breath.

Who to Call

Call 911 for emergencies.

If you have any questions or problems when you are home, call the Gyn/Onc Clinic at: (608) 263-1548.

If you are constipated and have nausea and vomiting, call the Gyn/Onc RN triage line/After Hours line at: (608) 263-1548.

After hours and weekends, the clinic number will connect you with the paging operator. Ask for the gynecology resident on call. Give your name and phone number with the area code. The doctor will call you back.

For clinic appointments call: (608) 265-1700 or (800) 323-8942.