second-look laparotomy
Planned re-exploration of the abdomen to assess tissue viability or address evolving pathology.
Full Definition
Second-look laparotomy is a planned surgical re-exploration of the abdomen performed at a predetermined interval to reassess tissue viability, particularly bowel perfusion, or to address evolving pathological conditions that may require intervention. This approach is commonly employed when initial surgery leaves questions about tissue viability that cannot be definitively answered at the first operation, such as in cases of mesenteric ischemia, questionable bowel viability following trauma, or after extensive adhesiolysis where bowel injury may become apparent later. The timing is typically 12-48 hours after the initial procedure, allowing sufficient time for tissue demarcation while preventing irreversible complications. During the second-look procedure, any non-viable tissue is resected, and definitive reconstruction may be performed if conditions are favorable.
Usage
Usage note: Distinct from unplanned re-operation for complications; this is a deliberate surgical strategy.
In Context
- "A second-look laparotomy was scheduled for 24 hours to reassess small bowel viability following mesenteric vessel repair." — vascular surgery operative report
- "The planned second-look laparotomy revealed well-perfused bowel, allowing primary anastomosis to proceed safely." — general surgery follow-up note