Laparotomy for ovarian cancer

A laparotomy is an operation to look inside your tummy (abdomen) and pelvis to find out if there is any cancer and if it has spread.

What is a laparotomy?

Your surgeon makes a large cut down the middle of your abdomen. They look inside your abdomen and pelvis and take samples of tissue (biopsies). 

Your surgeon sends the tissue samples to the laboratory. A specialist doctor (pathologist) looks at the samples under the microscope to check for cancer cells.

Sometimes they can check this during the operation. If there are cancer cells, your surgeon may continue with the operation and remove as much of the cancer as possible. They only do this if you already agreed to it before the surgery.

Before your laparotomy

Before your laparotomy, you have tests to check that you’re fit enough for the operation. A nurse weighs you and takes your blood pressure, pulse and temperature.

You might also have:

• blood tests
• a heart trace (ECG)
• a chest x-ray

You can ask any questions you might have and sign the consent form.

Tell your doctor if you’re taking medicine that changes how your blood clots. These medicines include:

• clopidogrel
• arthritis medicine
• warfarin
• aspirin
• direct acting oral anticoagulants (DAOCs) such as rivaroxaban

Your healthcare team will tell you if you need to stop your medicines or change the dose before the laparotomy.

You might need some medicine or an enema to help empty your bowels before your operation. Your healthcare team will tell you if this applies to you.

You can’t eat for some time before the operation. You might be able to have water for up to 2 hours beforehand. The hospital staff will give you instructions about this.

Tell your doctor if not eating could be a problem for you, for example if you have diabetes.

What happens?

You have the operation under general anaesthetic, so you are in a deep sleep. 

Your surgeon makes a large cut down the middle of your abdomen. They can look at the inside of your abdomen and pelvis. They take samples of tissue and fluid and send them to the laboratory. The length of the operation depends on how much tissue the surgeon needs to remove.

At the end of the operation, the surgeon uses stitches or clips to close the wound and covers it with a dressing.

After the laparotomy

After the operation you go to the recovery area. You then go back to your ward.  You might be in hospital for a few days.

The staff will monitor you closely. There will be a call bell close by so that you can call for help whenever you need it.

You usually have fluids through a drip in the back of your hand or arm. Once you’re fully awake and drinking, your nurse takes the drip out. You should be able to eat and drink normally once you feel able to.

You might have a tube into your bladder (catheter) to drain your urine. This stays in until you are moving around. 

You might have some pain in your abdomen for a few days. You have painkillers to help with this.

Your nurse will check the dressing covering your wound to make sure it's clean. Try to keep the dressing dry. You may have dissolvable stitches. Or you may have stitches or clips that need removing. The practice nurse at your GP surgery can usually do this.

Getting your results

You should get your results within 1 or 2 weeks at a follow up appointment, but it may take longer. 

Waiting for test results can be a very worrying time. You might have contact details for a specialist nurse who you can contact for information if you need to. It can help to talk to a close friend or relative about how you feel.

Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

Possible risks

Most people won’t have problems from this type of operation. Your doctor makes sure the benefits of having it outweigh the risks. These include:

• a wound infection – this is treated with antibiotics
• bleeding during or after surgery – you might need a blood transfusion or another operation
• a blood clot in your legs (deep vein thrombosis or DVT) – you should get up shortly after your operation to reduce the risk of blood clots
• damage to the bowel, bladder or main blood vessels – this is rare. You might need an operation to repair the damage

Your nurse tells you what to look out for before you go home. They also give you a phone number to contact if you have any problems.