A laparotomy is a large incision in the abdomen undertaken either through a pfannenstiel (caesarean) incision or as a midline cut from pubic bone to above the umbilicus.
This type of incision is rarely used these days in elective advanced gynaecological surgery; an exploratory laparotomy may be a preferred procedure by Gynaecologist Oncologists where the extent of spread of cancer is yet to be determined.
Laparoscopy vs laparotomy
For patients undergoing elective surgery for endometriosis, even those with 15cm endometrioma, or those undergoing bowel resection, in my experience, all such surgeries can be completed by laparoscopy (keyhole surgery).
As with all elective surgeries there is the potential for an adverse findings or outcome, and although extremely rare, the requirement to produce an optimal outcome when there is invasive disease of bowel, bladder, ureter or vessels may necessitate laparotomy.
How long does a laparotomy take?
These procedures would take an additional 1-3 hours to complete and would require the assistance of additional surgical expertise over a laparoscopy.
Laparotomy recovery time
The recovery time after laparoscopy is generally only 1-2 days; with laparotomy it may be 4-7 days in total.