Definition & Overview
Abdominal surgery is a broad classification of surgical procedures performed in the abdominal region to diagnose or treat a medical condition. It involves different techniques depending on which abdominal organ is involved, i.e. the stomach, liver, or kidney, among others. Most of these procedures traditionally require opening the abdomen with a large incision and are referred to as open abdomen surgeries or laparotomies, which are considered as major operations that are followed by extended recovery and down time period. However, newer techniques have paved the way for laparoscopic surgeries that only require significantly smaller incisions that leave less scarring and cause less post-operative pain.
Laparoscopic surgeries make use of tubes that are inserted into tiny incisions made on the patient’s body. The tubes are attached to a video camera that gives the surgeon a view of the abdominal interior as a guide during the surgery. Surgical instruments are also designed to work with the said tubes, completely eliminating the need for making large incisions. As a result, patients recover from the procedure faster and also experience minimal blood loss and minimal scarring. They also greatly reduce the risk of infection. This minimally invasive approach to abdominal surgery is becoming more and more in demand these days as laparoscopic technology continues to improve.
Who Should Undergo & Expected Results
An abdominal surgery is prescribed for patients who are suffering from diseases that affect any part of the abdominal cavity. Potential patients include those who are suffering from:
- Miscarriage/fetal death
- Unexplained symptoms affecting the abdominal cavity
- Unexplained bleeding in the abdomen
Most patients experience certain symptoms that prompt them to seek medical attention. These typically include pain, diarrhea, constipation, and any sudden change in bowel movements.
An abdominal surgery is intended to relieve the symptoms of abdominal injury or trauma, such as the pain caused by an inflamed or ruptured appendix or to control any bleeding. The surgery should also confirm the underlying causes of these symptoms to determine the appropriate course of treatment. Whenever possible, the underlying causes are also resolved during the same operation to eliminate the need for a separate surgical procedure later on.
Abdominal surgery is expected to cause temporary changes on the patient’s pain level, bowel movement, breathing, and diet.
How Does the Procedure Work?
There are a number of abdominal surgical procedures, and each is performed using different techniques.
Caesarean section – Dubbed as a C-section, this is an abdominal procedure used for childbirth purposes, i.e. delivery of full-term babies, although in complicated cases, it may also entail the removal of a dead fetus. This procedure requires making a large incision through the abdominal of the expectant mother in a method called laparotomy, and also through the uterus in a method called hysterotomy.
Inguinal hernia surgery – This is an abdominal procedure intended for the repair of an inguinal hernia. It involves creating an incision near the location of the hernia to remove the sac and later on, to push the intestine back into the abdomen. This is typically performed using laparoscopic techniques.
Exploratory laparotomy – This is a diagnostic surgery that aims to determine the source of bleeding or trauma that affects the abdominal organs and causes distressing symptoms to the patient. This involves opening the abdominal cavity to directly examine the contents of the abdominal cavity. If the situation allows, the same procedure is used to repair or remove the problem.
Cholecystectomy – This is an abdominal surgery intended to remove the gallbladder. This is the most common type of laparoscopic abdominal surgery at present.
Appendectomy – This abdominal surgery is intended for people suffering from appendicitis, or the inflammation of the appendix. This is the definitive course of treatment for appendicitis and involves removing the appendix altogether. In some cases, the appendix may rupture, making an appendectomy an urgent procedure to avoid complications.
Regardless of the specific type of abdominal surgery that will be performed, the preparations are generally the same. Patients are prepped by making them change into a surgical gown and removing any artificial objects such as dentures or contact lenses. The patient’s vital statistics are then recorded, with some values, such as body temperature, pulse rate, and blood pressure continuously monitored throughout the procedure. An IV line is also inserted into the patient’s vein for the administration of fluids and medications needed during the surgery. The procedure begins following the administration of anaesthetics.
For laparotomies, patients usually need to stay in the hospital for 5 days or even longer, but this period can be reduced in the case of laparoscopic patients. To avoid complications, patients are advised to sleep alternately on their back and on their side, with changes occurring every 2 hours. Patients should also expect to feel slightly weak during the first several weeks after the procedure.
Patients who have undergone abdominal surgery typically need to return to the doctor to remove the staples used for suturing. If there are any complications, the patient can be re-admitted to the hospital.
Possible Complications and Risks
Patients who have undergone an abdominal surgery are closely monitored for potential complications and risks, which may include but are not limited to:
- Scar tissue
- Paralytic ileus or temporary paralysis of the bowel
These complications can be prevented by ensuring sterile techniques and administering aseptic care post-surgery.
Sterile techniques can be expected during scheduled operations as medical professionals as well as their staff take necessary measures to ensure that the environment is free from disease-causing contaminants. However, this can be harder to control for surgeries that are performed under emergency situations in unsterile environments. This is crucial in procedures that involve the abdominal due to possible leakage of bowel contents, which is more common in cases involving abdominal trauma.
However, most complications can be managed as long as the patient brings them to the attention of the doctor. Pain can be addressed with pain relievers while a round of antibiotics prevents an infection from developing.
- McGrath MH, Pomerantz J. Plastic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 69.