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Laparotomy, also known as celiotomy, is performed by making a large incision in the abdomen to gain access to the peritoneal cavity. A standard laparotomy usually involves a sagittal, midline incision along the linea alba. This activity describes the indications, contraindications and complications of celiotomy and highlights the role of the interprofessional team in the management of patients with requiring this procedure. Objectives: Describe the indications for celiotomy. Review the contraindications to celiotomy. Summarize the potential complications of a celiotomy. Explain interprofessional team strategies for optimizing care coordination and communication to advance appropriate and effective approaches to celiotomies to improve clinical outcomes. Access free multiple choice questions on this topic.

The word laparotomy is derived from the Greek words lapara, meaning flank, and tomy, meaning cut. In surgical practice, this translates to a big cut in the abdomen to gain access to the peritoneal cavity. Usually, a standard laparotomy is a cut made in the midline along the linea alba. In the United Kingdom, this is a common procedure with approximately 30,000 to 50,000 performed annually.[1]

Complications of a laparotomy can be site-specific or general but are usually influenced by factors at the time of the operation. As such, it can be classified as patient-related or operator-dependent and, of course, should take into account the operation itself. The following is a broad list of possible complications: Bleeding Infection Bruising Seroma/ hematoma Wound dehiscence Necrosis Incisional hernia Chronic pain Skin numbness Fistulation with underlying structures Raised intra-abdominal compartment pressure Damage to underlying structures Poor cosmesis

Key personnel usually present at a laparotomy include the surgeon, surgeon’s assistant, scrub nurse, anesthetist, operating department practitioner, and some theatre staff to act as runners in case more kit is required. The operating room nurses are required to set up the instruments and do a pre and post count of sponges, needles and other equipment used during the procedure. In general, no patient should leave the operating room with missing sponges or needles. Every hospital has protocols that both nurses and surgeons need to follow to ensure that no unintended item is ever left inside the patient.