Laparoscopic treatment of small bowel obstruction: Prospective evaluation in 30 patients

Laparoscopic treatment of small intestinal obstruction is associated with immediate advantages and it may be expected that the recurrence rate will be decreased because of the reduction of wound scars. Between September 1989 and October 1994, 30 patients (19 men and 11 women), mean age 54.4 years, underwent initial laparoscopy for acute small intestinal obstruction. These patients had undergone a total of 52 (1.6 per patient) laparotomies, 15 years before, on average. One patient had never been operated on, 15 had one previous laparotomy, seven had two, five had three, and two had four previous laparotomies. Laparoscopic treatment of intestinal obstruction was possible in 10 cases, including three cases of bands, and six instances of adhesion and one small bowel strangulation in a trocar hole from a previous laparoscopy. In 20 cases, laparoscopy had to be completed by laparotomy, 17 immediately and three secondarily. The cause of immediate failure was the impossibility of finding and/or treating the cause...