Bowel obstruction surgery. Close-up of surgeons carrying out an exploratory laparotomy for small bowel obstruction. A laparotomy is a surgical procedure where a large incision is made through the abdominal wall to access the abdominal cavity. A bowel obstruction is a medical emergency where an obstruction occurs at any level below and including the duodenum, the first part of the small intestine. Here, the surgeon is palpating a caecal mass, and distended small bowel loops are seen in the foreground.