THE LAPAROSCOPIC 2ND LOOK FOR ISCHEMIC BOWEL-DISEASE

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.