Exploration of the abdomen

The findings at 1500 consecutive laparotomies are reported. The likelihood of finding an alternative condition to the preoperative diagnosis and of discovering important incidental findings is so high that complete abdominal exploration should be carried out whenever possible at routine abdominal operations. However, laparotomy is no substitute for careful preoperative investigation. Routine preoperative endoscopy is recommended before all operations on the upper gastrointestinal tract. If no cause for symptoms is found at operation no procedure should be carried out; the placebo effect of laparotomy and subsequent assurance often leads to alleviation of the symptoms.