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Laparotomy

Laparotomy and laparoscopic surgery are performed on the abdomen to diagnose peritoneal malignant mesothelioma.

Peritoneal mesothelioma is cancer of the lining of the abdomen. There are approximately 400-600 cases of malignant peritoneal mesothelioma in the United States per year. That figure represents 10-15% of all the cases of malignant mesothelioma diagnosed a year. The peritoneum is the second most frequent site of origin after the pleural lining of the lung. The same risk factor – exposure to asbestos – occurs in both pleural and peritoneal mesothelioma.

Symptoms of malignant peritoneal mesothelioma can include abdominal distension. This occurs in as many as 80% of those diagnosed. Other symptoms of malignant peritoneal mesothelioma include pain, anorexia, dyspnea- shortness of breath and chest pain. There is no one specific symptom of malignant peritoneal mesothelioma and it is often found in women when they are having a medical work-up for another issue. The average time between onset of symptoms and diagnosis is approximately 5 months.

Treatment of malignant peritoneal mesothelioma can include an exploratory laparotomy. Exploratory laparotomy is performed in order for the surgeon to visualize and examine the organs and structures of the abdominal cavity.

There are different reasons to perform an exploratory laparotomy. One of the leading causes is trauma often caused by gunshot wounds, stabbing, or anything that could cause bleeding into the abdominal cavity. Bleeding into the abdominal cavity is considered a medical emergency. By opening the abdominal cavity, the surgeon can visualize the organs, blood vessels, and tissues in the abdominal cavity. Another reason is abdominal pain of unknown etiology. The laparotomy procedure is used to determine the source of the pain enabling the surgeon to visualize the abdominal cavity. Staging of cancer is also a reason for an exploratory laparotomy. The wide incision allows the surgeon to examine the organs and look for evidence of spreading of cancer.

For treatment of peritoneal mesothelioma, the parietal layer covers the abdominal cavity, while the visceral layer surrounds the stomach, liver, and other organs of the abdomen.

Heated intraoperative chemotherapy is administered once the surgeon has removed the visible peritoneal cancer. This chemotherapy fluid circulates throughout the abdomen. Certain mesothelioma centers will leave drains in the abdomen to reinfuse the abdominal area within the next few days following surgery.

The first laparotomy procedure is credited to Dr. Frank Zurfley in 1842. He operated on a patient that had suspected hemorrhaging in the abdomen after trauma. Minimally invasive laparoscopic approach is used more frequently than exploratory laparotomy currently. As the equipment has improved and surgeons have become more experienced with the minimally invasive procedure, laparotomy has been utilized less than before.

After an abdominal laparotomy it is important for the patient to move around. Walking helps the intestines to start working again. Often, patients will have a nasogastric tube in their nose running down to the stomach. This tube drains the stomach and usually is left in place until the patient is able to pass gas. Some of the most common complications of this surgery are infection, incisional hernia and ileus, which is lack of movement of the intestines. This can lead to buildup and potential blockage of food and materials. An ileus can lead to an intestinal obstruction. At that point no food, gas or liquid can get through. Pain can be controlled through epidural or intravenous medications until the patient is able to take medicine by mouth.

Recovery time from a laparotomy is usually 2-6 weeks. Infection is the most common complication. Monitoring for any signs of infection is an important part of the post-op care. Any redness, drainage, separating of the incision line, fever must be reported immediately.

An abdominal laparotomy is a wide incision on your abdomen. It is used for cytoreductive surgery for peritoneal mesothelioma. This procedure combined with heated intra-op chemotherapy, and an experienced surgeon and specialized mesothelioma team has improved the treatment of mesothelioma.

 

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Did You Know?

  • Mesothelioma Facts
    Mesothelioma Facts
    The highest award of compensatory damages ever upheld on appeal in a mesothelioma case is $30.3 million.
  • Mesothelioma Facts
    Mesothelioma Facts
    The largest punitive damages verdict ever upheld on appeal in a mesothelioma case is $18 million.
  • Mesothelioma Facts
    Mesothelioma Facts
    There are over $30 billion in asbestos trust funds to compensate victims of mesothelioma and other asbestos-related diseases.
  • Mesothelioma Facts
    Mesothelioma Facts
    There are more than 50 bankruptcy trusts accepting claims to compensate victims of mesothelioma and other asbestos-related diseases.
  • Mesothelioma Facts
    Mesothelioma Facts
    There are many “asbestos dockets” that permit living mesothelioma patients to obtain a jury verdict in less than 1 year.
  • Mesothelioma Facts
    Mesothelioma Facts
    In 2015, more than 2000 mesothelioma cases were filed in the United States.
  • Mesothelioma Facts
    Mesothelioma Facts
    In some mesothelioma cases, settlements can be obtained in less than 1 year.
  • Mesothelioma Facts
    Mesothelioma Facts
    Thousands of different companies have been defendants in mesothelioma cases over the past 40 years.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of 77 peritoneal mesothelioma cases, the average life expectancy (median survival period) was 75.7 months, or over 6 years.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of 77 peritoneal mesothelioma patients, 73.8% were living after 3 years, and 65.3% were living after 5 years.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of 77 peritoneal mesothelioma patients, 64% were treated with HIPEC and cytoreductive surgery.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of 303 pleural mesothelioma patients, the average life expectancy (median survival period) was 18.4 months.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of pleural mesothelioma patients, 73.1% were still living after 1 year, and 22.9% were still living after 3 years.
  • Mesothelioma Facts
    Mesothelioma Facts
    In 2015, the largest number of mesothelioma cases were filed in the following 10 courts: (1) Madison County, IL; (2) Cook County, IL; (3) St. Louis, MO; (4) Los Angeles, CA; (5) New York, NY; (6) Philadelphia, PA; (7) New Castle County, DE; (8) Middlesex County, MA; (9)Middlesex County, NJ; (10) Kanawha County, WV.
  • Mesothelioma Facts
    Mesothelioma Facts
    The states with the largest number of diagnosed mesothelioma cases are: New York, New Jersey, California, Washington, Pennsylvania, Massachusetts, Virginia, Florida, Texas, Illinois, Wisconsin, Michigan and Ohio.
  • Mesothelioma Facts
    Mesothelioma Facts
    There are about 3000 mesothelioma cases diagnosed in the United States each year.
  • Mesothelioma Facts
    Mesothelioma Facts
    About 1 in 100,000 people in the United States will be diagnosed with mesothelioma each year in the United States.
  • Mesothelioma Facts
    Mesothelioma Facts
    More than 80% of all mesothelioma cases occur in the pleura (pleural mesothelioma).
  • Mesothelioma Facts
    Mesothelioma Facts
    Less than 20% of all mesothelioma cases occur in the peritoneum (peritoneal mesothelioma).
  • Mesothelioma Facts
    Mesothelioma Facts
    About 22% of all mesothelioma cases occur in women.
  • Mesothelioma Facts
    Mesothelioma Facts
    A history of asbestos exposure can be found in more than 80% of mesothelioma cases.
  • Mesothelioma Facts
    Mesothelioma Facts
    More than 30% of all mesothelioma patients in the United States were exposed to asbestos in the military.
  • Mesothelioma Facts
    Mesothelioma Facts
    Mesothelioma can be caused by laundering, or other household contact with, work clothing contaminated with asbestos.
  • Mesothelioma Facts
    Mesothelioma Facts
    Mesothelioma can be caused by work with (direct exposure) or around (bystander exposure) asbestos-containing products.
  • Mesothelioma Facts
    Mesothelioma Facts
    The average time between a person’s first exposure to asbestos and the development of mesothelioma (latency period) is more than 40 years.
 

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