1. Introduction

2. Incision and Access to Abdominal Cavity

3. Abdominal Exploration

a. Resection of Injured Small Bowel

b. Side-to-Side/Functional End-to-End Anastomosis

4. Small Bowel Repair

5. Lesser Sac Examination

6. Right Colon Mobilization and Examination of Ureter

7. Partial Cecectomy to Repair Colonic Defect

8. Summary and Final Exploration

a. Debrief

9. Closure

Gunshot wounds to the abdomen are one of the most classic trauma cases a surgeon will come across in their career. The high velocity of a bullet can cause massive internal and external trauma to the abdomen. Exploration of the small bowel using laparotomy is often indicated after a penetrating traumatic injury or when peritoneal signs are present. This video article shows the most common techniques for performing an exploratory laparotomy. In this case, the abdomen was explored and was revealed to show a through-and-through gunshot wound to the jejunum, as well as a partial-thickness tear of the proximal cecum; the abdomen was explored for any smaller bleeds or leaks, and the abdomen was closed.

Watch this full-length, narrated surgical video of an exploratory laparotomy in a hemodynamically stable patient who sustained an abdominal gunshot wound.

UChicago Medicine