​What kinds of symptoms do patients experience before receiving treatment?

A laparotomy is a surgical procedure in which surgeons create a large incision through the abdominal wall to gain access into the abdominal cavity. A laparotomy is often performed to examine the abdominal organs and aid diagnosis of the cause of abdominal pain. It may be performed to remove cancer of the intestines, repair bowels and remove blockages, or to remove ovarian cysts.

​What is the impact on patients’ lives of living with these conditions?

Any of the conditions that would warrant a laparotomy can be life-threatening. A blocked bowel can cause tissue death, as blood supply may be cut off to all or part of the intestine. An ovarian cyst can cause extreme pain and can rupture, spreading infection. Rupture of an ovarian cyst can also produce severe pain and internal bleeding.

What cultural or regional factors affect the treatment of these conditions?

This surgery has no cultural significance.

What does the treatment process look like?

A patient will present at the hospital complaining of abdominal pain. A medical officer will examine the patient and determine the location and possibly the cause of the patient's distress. After examination, the medical officer and the surgeon will determine a plan of action. If a laparotomy is needed, the patient will be admitted to the hospital, and relevant tests will be undertaken. Surgery will be scheduled, usually within one or two days. Prior to surgery, the patient will be counseled by the surgeon on possible outcomes and what to expect. The morning of surgery, the patient will be seen by the anesthetist to determine the appropriate anesthesia. After surgery, the patient will recover in post-op for approximately thirty minutes. Depending on the extensiveness of the surgery, the patient will be hospitalized for approximately five days with daily reviews by the medical officer.

What is the impact of this treatment on the patient’s life?

A laparotomy is undertaken when physicians and surgeons determine that a patient's diagnosis is serious enough to warrant open abdominal surgery. This treatment saves lives.

What potential side effects or risks come with this treatment?

Laparotomy is a major surgery, and any complicated surgery has risks and possible side effects. Severe bleeding may occur from large blood vessels, although this is not common. Infection in the operation site, pelvis, or urinary tract may occur. Treatment may include wound dressings and antibiotics.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

The nearest alternate hospital with a qualified surgeon is over two hours away on rough dirt roads.

What are the alternatives to this treatment?

It is sometimes possible to perform operations by keyhole surgery (laparoscopy). However, laparoscopy is not available in rural Uganda, necessitating more extensive open abdominal laparotomy.