Background: Survival after acute vascular ischemia depends on a second
look laparotomy to detect extending bowel compromise and to verify th
e integrity of the anastomosis, In a series of five consecutive patien
ts with acute ischemic bowel desease, we used laparoscopic technique t
o determine if a formal laparotomy could be avoided. Methods: followin
g the resection of ischemic bowel in five consecutive patients, two la
paroscopic trocars were inserted in the lower abdominal quadrants and
covered by sterile gloves. Forty-eight to 72 h following the primary o
peration, the abdomen was inflated via a trocar and secondary assessem
ent done by laparoscopy. Results: In all patients, the integrity of th
e anastomosis and viability of the remaining bowel was accurately asse
ssed by laparoscopy. Conclusions: Using mininally invasive techniques,
a second look laparotomy was avoided in 5 patients with ischemic bowe
l disease.