Laparoscopic adhesiolysis for bowel obstruction, preliminary results

ABSTRACT

Recurrent small bowel obstruction caused by postoperative adhesions has traditionally been treated by conventional laparotomy, but laparoscopic management of acute small bowel obstruction has been demonstrated. Our aim was to evaluate the feasibility of a laparoscopic as a minimal access approach for the management of patients with recurrent adhesive intestinal obstructions. After conservative treatment, elective laparoscopic treatment was attempted in 22 patients hospitalized for recurrent small bowel obstruction after abdominal surgery. The sites of postoperative adhesions were identified laparascopically in all patients. Complete laparoscopic adhesiolysis was feasible in 17 patients [77.3%], while conversion to laparotomy was required for 5 patients [22.7%] due to iatrogenic intestinal injury during adhesiolysis [one patient] or technical difficulties due to adhesion [in four patients]. The mean operating time was 95 minutes. Long-term follow up was possible in three patients for 27 months. One recurrence of small bowel obstructions was noted after 7 months. No available data was obtained [in two patients]. Laparoscopic adhesiolysis is a safe and effective treatment for recurrent small bowel obstruction. Conversion to laparotomy should be considered in patients with dense adhesions