Role of Laparoscopic Adhesiolysis in Adhesive Intestinal Obstruction

Document Type : Original Article

Authors

1 General surgery department, faculty of medicine, Zagazig university

2 Department of general surgery,faculty of medicine,zagazig university

3 department of general surgery,faculty of medicine,zagazig university

Abstract

Background: Adhesive Intestinal obstruction is an inevitable complication of abdominal surgeries with significant morbidity associated with poor quality of life and predispose to repeated hospitalization. Laparoscopy has been shown to decrease the incidence, extent, and severity of intraabdominal adhesions when compared with open surgery, thus potentially decreasing the recurrence rate for adhesive small bowel obstruction. However, laparoscopic adhesiolysis has not gained wide acceptance because of concerns regarding iatrogenic injury to the bowel and limited visualization secondary to distended bowel.
Subjects and method: Between the period of November 2017 and June 2019in the General Surgery Department of Zagazig university Hospitals 12 patient included 6 males (50.0%) and 6 females (50.0%) with mean age (38.4±7.1) complaining of adhesive intestinal obstruction all of them were operated laparoscopically for lysis of adhesions.
Results: laparoscopic adhesiolysis was done in (58.3%) of the study group followed by laparoscopic adhesiolysis with intraoperative enterotomy (25.0%) and lastly Conversion to open procedure for lysis of adhesions due to excessive adhesions was done in (16.7%) of the study group.
Conclusions: Laparoscopic adhesiolysis has been shown to be safe and feasible in experienced hands. Patients who require an emergent operation are good candidates for laparoscopic adhesiolysis. Patients who have a chronic or recurrent partial obstruction documented on a contrast study are also good candidates for laparoscopic adhesiolysis.

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