Laparoscopic Management as the Initial Treatment of Acute Small Bowel Obstruction

Laparoscopic Management as the Initial Treatment of Acute Small Bowel Obstruction

Henry J. Lujan, MD, Aeyal Oren, DO, Gustavo Plasencia, MD, Gustavo Canelon, MD, Eddie Gomez, MD, Alejandro Hernandez-Cano, MD, and Moises Jacobs, MD

Advanced Surgical Institute, Miami, Florida, USA.

Corresponding author.

Presented as an open forum at the 12th International Congress and Endo Expo 2003, SLS Annual Meeting, Las Vegas, Nevada, USA, September 22–25, 2003.

Address reprint requests to: Henry J. Lujan, MD, FACS, FASCRS, Advanced Surgical Institute, 3661 S Miami Ave, Ste 301, Miami, FL 33133, USA. E-mail: hlujan1000@aol.com

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.

Objectives:

We prospectively evaluated our experience with laparoscopic management of acute small bowel obstruction (SBO).

Methods:

The study group included all patients requiring surgical intervention based on complete mechanical SBO by clinical assessment or who had failed conservative management. Patients with malignant causes were excluded. Experienced laparoscopic surgeons performed all operations.

Results:

Between January 1998 to January 2003, 61 patients required operative intervention for acute SBO. Causes included adhesions, internal hernia, incarcerated incisional hernia, and inflammatory bowel disease. Laparoscopic techniques (LAP) alone were successfully used to complete 41 cases (67%). Twenty patients (33%) were converted (CONV) to either mini-laparotomy [7 patients (35%)] or standard midline laparotomy [13 patients (65%)]. A single band was identified in 25 patients (41%). Complications occurred in both groups.

Conclusions:

We believe all patients requiring surgery in the setting of acute...