Access to the Abdomen: Emergency Laparotomy

Abstract

The emergency laparotomy includes tasks and strategies that are drastically different than the elective laparotomy. The surgeon is constantly fighting an unforgiving foe: time. A moderately longer operation has little effect in outcome on a patient who is physiologically stable and not losing blood. On the other hand, every intraoperative minute counts on patients in metabolic disarray and hemodynamic collapse. Therefore, the entire philosophy of emergency abdominal access is dominated by the focus on minimizing time, while not compromising adequate exposure and technique. A standardization of tasks will prevent missed injuries, wrong procedures, or retained sponges, all of which are associated with emergency operations.