Mini-laparotomy

Mini-laparotomy is open surgery through a small, low incision across the abdomen. The incision is much shorter than the one for a standard laparotomy. It gives the surgeon direct access to the pelvis. Surgeons use it when laparoscopy, surgery through small ports with a camera, is not a good fit. It offers a practical middle ground. In some cases it gives more working room than laparoscopy. It also places less strain on the body than a full laparotomy.

Reasons for its use in pelvic surgery include dense scar tissue (adhesive disease) that blocks the view through the scope. They also include a very large fibroid or a very large ovarian mass. Another reason is a pelvis so distorted that work through small ports carries too much risk.

Surgeons often pair it with the principles of near adhesion-free reconstructive pelvic surgery. In hard cases, an open incision allows more thorough rinsing of the pelvis (irrigation). It also allows more precise placement of barriers and better control of bleeding.

Some surgeons prefer it over laparoscopy for tubal reversal and other repair work. An open field lets them work directly with their hands. They can also use loupes or an operating microscope. These tools magnify the fine stitching that microsurgery demands. The right choice depends on the patient's anatomy and prior surgeries. It also depends on the surgeon's training.