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 surgeons are 'running' the distended small intestine, examining it and looking for the point of obstruction.