Laparotomy for ovarian cancer

A laparotomy is an operation to look inside your abdomen and pelvis to find out if ovarian cancer has spread. You might be in hospital for a couple of days. 

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 doctor 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 doctor may continue with the operation to remove as much of the cancer as possible. They only do this if you already agreed to it before the surgery.

Before your laparotomy

You go to the hospital in the 2 weeks before your laparotomy 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 doctor tells you if you need to stop your medicines or change the dose before the laparotomy.

You can’t eat for 6 hours 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. 

Your surgeon makes a large cut down the middle of your abdomen so 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 stitches the cut 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 couple of days.

Your nurse checks your pulse, blood pressure and temperature.

You might 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 for 1 or 2 days and then the nurse removes it. 

You might have some pain in your abdomen for a few days. Your nurse will give you some painkillers to help with this.

Your nurse removes the dressing on the second day, and makes sure your wound looks clean and dry. You may have dissolvable stitches. Or you may have stitches that need to be taken out. The practice nurse at your GP surgery can usually remove them about 7 days after your operation.

Getting your results

You should get your results within 1 or 2 weeks at a follow up appointment. 

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.