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This Concept Map, created with IHMC CmapTools, has information related to: Exploratory Laparotomy, Process Step insert needle ventral to transverse process (L1,2 and 4) infuse 10 ml of Lidocaine in fan shape pattern (at each site), [m.o.] Pre-Operative Procedure Entails Preparation of surgical site (m.o), [m.o.] Pre-Operative Procedure Entails indications (m.o), Procedure Step 1 desensitize skin close to the transverse process of L1, L2, L3 using 18 gauge needle 2 to 3ml lidocaine, Distal Involves Nerves (m.o), Physical Involves 5 station exam (m.o), Exploratory laparotomy Objectives Intra-Operative Procedure, Exploratory laparotomy Objectives [m.o.] Pre-Operative Procedure, Physical Involves Techniques (m.o), line block Involves Needle (m.o), Pre-anaesthetics Involves inverted L block, Intra-Operative Procedure step 1 see left flank, [m.o.] Pre-Operative Procedure Entails Examination, [m.o.] Pre-Operative Procedure Entails Equipment (m.o), systematic exploration of abdominal cavity step 4a if no abnormalities are found incision is closed in 3 layers, if no abnormalities are found incision is closed in 3 layers layer 1 peritoneum and transverse abdominal m. pattern - simple continuous suture material - no. 0 or 1 synthetic absorbable direction -ventral to dorsal, Post-Operative Procedure Entails Revisit (m.o), peritoneum and transverse abdominal m. pattern - simple continuous suture material - no. 0 or 1 synthetic absorbable direction -ventral to dorsal layer 2 int. and ext. abdominal oblique m. pattern - simple continuous material - no. 1 synthetic absorbable, vertical incision is made - middle of paralumbar fossa - 3 to 5cm ventral of tr. process of lumbar vertebrae for approx. 20 -25cm step 2 tissues are incised in the following order (mo) - skin - subcutaneous - ext. abdominal oblique m. - int. abdominal oblique m. - transverse abdominal muscle - peritoneum, Examination Includes Distance