What is the Difference between Laparotomy and Laparostomy?

Difference between Laparotomy and Laparostomy

Laparotomy

Laparostomy

Surgical opening of the abdominal cavity  is known as Laparotomy. If the laparotomy wound is kept open with the help of sterile covering, it is called Laparostomy.

The purpose of keeping the laparotomy wound open is to prevent the closure of the abdomen under tension.  If  the abdomen is closed under tension it can lead on to  Abdominal compartment syndrome.

The laparostomy helps to inspect the abdominal content in the immediate post operative period. This is known as the Second look laparotomy.

The laparostomy wound can be closed once the general condition of the patient is improved. Hence it is also known as Damage Control Surgery.

What is Abdominal compartment syndrome?

The intra abdominal pressure is increased in Blunt Trauma Abdomen or in Intestinal Obstruction.  The increased intra Abdominal Pressure  can result in the gangrene of the intestine due to compromised vascularity.This condition  is known as Abdominal Compartment Syndrome.

How can the possibility of Abdominal Compartment Syndrome is anticipated?

After Laparotomy, during closure of the abdomen if the Intestines are lying above the level of the brim of the laparotomy wound, the closure is going to be under tension and one should anticipate the possibility of Abdominal Compartment Syndrome.

Clinically Abdominal compartment syndrome is suspected when :-

1.The Abdomen is tensed to feel.

2.The urine out put is decreased.

3. The Intra Abdominal Pressure is Increased

How can we measure Intra Abdominal Pressure?

Intra Abdominal Pressure is considered equivalent to Intra vesical Pressure (Pressure inside the Urinary Bladder). The  Intra Vesical Pressure can be measured by catheterizing the urinary bladder and connecting the Foley’s catheter to a Manometer.