A Comparison of Standard Laparoscopic Surgery and Hand-Assisted Laparoscopic Surgery in Patients with Diverticular Diseases of the Large and the Small Bowel

Small bowel obstruction after intra-abdominal surgery is a common cause of morbidity necessitating reoperation. The aim of this study was to determine the feasibility of and indications for laparoscopic surgery for acute adhesive small bowel obstruction (AASBO). We conducted a retrospective review of all patients with AASBO who underwent laparoscopic adhesiolysis at a major university medical center. Laparoscopic treatment was performed successfully in 16 patients, and conventional treatment was performed in 13 patients. The rate of conversion from laparoscopic to open was 16.7 per cent. In 15 of 16 total patients who underwent laparoscopic surgery, laparoscopic bandlysis was performed and one patient underwent laparoscopic adhesiolysis. Laparoscopic surgery was performed successfully in nine who had a single adhesive band demonstrated on an abdominal CT, and conventional surgery was performed in all 10 patients without a single adhesive band identified radiographically. Abdominal CT scans facilitate the selection of operative approach for AASBO based on preoperative identification of the obstruction site. Laparoscopic adhesiolysis is a safe and effective treatment modality for patients with AASBO with a single band or single transition zone identified by preoperative imaging.

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Laparoscopic Surgery for Small Bowel Obstruction

Advances in Surgery ◽

10.1016/j.yasu.2018.03.001 ◽

2018 ◽

Vol 52 (1) ◽

pp. 15-27

Author(s):

Ramy Behman ◽

Avery B. Nathens ◽

Paul J. Karanicolas

Keyword(s):

Laparoscopic Surgery ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction

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Single incision laparoscopic surgery in general surgery: a review

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x590358 ◽

2011 ◽

Vol 93 (6) ◽

pp. 437-440 ◽

Cited By ~ 55

Author(s):

N Greaves ◽

J Nicholson

Keyword(s):

Laparoscopic Surgery ◽

General Surgery ◽

Single Incision ◽

Case Series ◽

Published Data ◽

Single Incision Laparoscopic Surgery ◽

Complication Rates ◽

Post Operative Pain ◽

Randomised Controlled ◽

Standard Laparoscopic Surgery

Single incision laparoscopic surgery (SILS) is a rapidly developing field that may represent the future of laparoscopic surgery. The major advantage of SILS over standard laparoscopic surgery is in cosmesis, with surgery becoming essentially scarless if the incision is hidden within the umbilicus. Only one incision is required so the risk of potential complications like port site hernias, haematomas and wound infection is reduced. The trade-off for this is a technically more challenging procedure with different underlying principles to that of traditional laparoscopic surgery. A wide variety of new equipment has been developed to support SILS and the range of procedures that are amenable to the technique is increasing. To date most of the published data relating to SILS are in the form of case series, with the first large randomised controlled trials due to be completed by the end of 2012. The existing evidence suggests that SILS is similar to standard laparoscopic surgery in terms of complication rates, completion rates and post-operative pain scores. However, the duration of SILS is longer than equivalent laparoscopic procedures. This article discusses SILS with regard to its applications in general surgery and reviews the evidence currently available.

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