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Consent to Perform Exploratory Laparotomy

VetBooks.ir Patient name:_________________________________
Pet owner’s name:_____________________________ Med rec #____________
Best contact during/after procedure (e.g., cell phone number):____________________

INTRODUCTION FORESEEABLE RISKS TO THE PROCEDURE
We want to make sure that you understand the planned medical An exploratory laparotomy is a major surgery. Primary risks of
procedure to be performed on your pet. You should know why the surgery include bleeding (which can be severe or life-threatening if
procedure has been suggested, what the potential benefits are for not controlled), infection, and re-opening (dehiscence) of the surgical
your pet, and the most common/important risks of the procedure. site. If an incision is made into certain organs, such as the stomach,
Alternatives to this procedure, when applicable, will be discussed intestines or bladder, there is a risk that the contents of that organ
with you. It is also important that you recognize that medicine is could leak into the abdomen; this could be life-threatening and would
not an exact science, and that the outcome cannot be guaranteed. likely warrant additional surgery. Patients may develop low blood
We encourage you to ask us as many questions as required for pressure during or after surgery that requires special medications and
you to make a well-informed decision. intensive care or may require a blood transfusion if there is excessive
bleeding. Occasionally, abnormal heart rhythms can develop after
BENEFITS/OPTIMAL OUTCOME OF THE PROCEDURE surgery that are generally temporary but can be serious and require
An exploratory laparotomy is a surgical operation to enter the medications. Most pets will require at least one night in the hospital
abdominal cavity and visualize the internal organs. It can be used following surgery for supportive care, pain medications, IV fluids,
as a diagnostic test (such as when taking biopsies of the liver or and monitoring. When your pet goes home, it is likely that he or she
intestines) or as a treatment (such as when removing an intestinal will be required to wear a cone-shaped collar (Elizabethan collar)
foreign body or bleeding tumor). The term “exploratory” comes to prevent chewing at the sutures. Less severe risks associated
about as this surgery allows all of the abdominal contents to be with surgery and anesthesia include stomach upset or diarrhea,
seen and felt by the surgeon—often identifying problems that were coughing, fever, or pain. As a worst-case scenario, cardiac arrest
not specifically recognized before the surgery. and death are also possible, though all reasonable precautions
are taken to try to prevent negative outcomes. Finally, there is a
EXPLANATION OF THE PROCEDURE risk that we will not identify a specific cause of your pet’s illness
An exploratory laparotomy allows the surgeon to examine all of despite performing an exploratory surgery.
the organs within the abdomen. With your pet under general
anesthesia, an incision is made through the skin and muscles on Other anticipated risks specific to your pet:___________________
the belly to expose the internal organs. The organs, including the
liver, gallbladder, spleen, kidneys, stomach, intestines, pancreas, _________________________________________________________
urinary bladder, lymph nodes, and adrenal glands are inspected for
any abnormalities. If an abnormality is detected, additional surgical
procedures, such as biopsies, organ removal, or removal of any ALTERNATIVES TO THE PROCEDURE
masses or foreign objects may be performed. The inside of the Other tests may help with the diagnosis of disease within the
abdomen is then thoroughly flushed with sterile fluid and the muscles, abdomen. Imaging studies, such as x-rays, ultrasound, or advanced
fat, and skin are closed with sutures (stitches) or surgical staples. imaging such as CT scan / MRI may be helpful for detecting abnor-
Common reasons to perform an exploratory laparotomy include malities within the organs of the abdomen. Blood and urine tests
suspicion of a foreign object or blockage in the stomach or intestines, may also help us reach a diagnosis. If these tests suggest a problem
removal of a tumor within the abdomen, removal of stones within within a specific organ, needle biopsies with ultrasound guidance
the bladder, internal bleeding, or to obtain diagnostic biopsies when allow for a small sample of cells to be analyzed for infections or
a chronic disease of one of the abdominal organs is suspected. certain types of cancers, although this can be less effective than a
Multiple procedures are sometimes performed at once. We will surgical biopsy during exploratory laparotomy. Endoscopy can be
discuss in detail the reason surgery is recommended for your pet. used to obtain biopsies inside the stomach and parts of the intestines.
Additional procedures planned for your pet at the same time There are also sometimes less invasive surgical options, such as
as the exploratory laparotomy: laparoscopy (“minimally-invasive surgery”). During a laparoscopy,
a special endoscope is inserted into the abdomen through a very
____________________________________________________________ small hole in the body wall to allow visualization of the abdominal
organs and even biopsy. We can discuss what diagnostic alternatives
USE OF SEDATIVES OR ANESTHESIA might exist for your pet, and the advantages and disadvantages
Exploratory laparotomy is a major surgery and requires general of each.
anesthesia. This means that your pet will be unconscious. Although There may be alternative options for treatments most commonly
anesthesia is performed routinely with good outcomes, it does bring performed during laparotomy. If there is a foreign object in the
risks, including a small risk of anesthetic-related death. These risks stomach, endoscopy may allow for removal without need for surgery
may be increased for animals with severe disease. Precautions will if the object is small enough and can be retrieved safely. If the foreign
be taken to minimize these risks, but they can never be eliminated. object has moved lower down into the intestines before getting
The decision to perform this surgery is based on the assessment stuck, surgery is generally required. There are other examples of
that the benefits outweigh the anesthetic risks. alternative treatments that may be less invasive than laparotomy.

From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.