THE ABDOMINAL DRAIN - A CONVENIENT PORT FOR 2ND-LOOK LAPAROSCOPY

Abdominal reexploration may occasionally be necessary in cases of doub tful bowel viability and intraabdominal sepsis. When this is indicated , second-look laparoscopy may be a useful alternative to conventional surgery, because it avoids subjecting an often critically ill patient to the trauma and risks of relaparotomy. Performing the laparoscopy th rough a cannula fitted to a flexible tube drain, inserted at the first laparotomy or laparoscopy, is proposed. The drain is withdrawn slight ly, a laparoscopic cannula is inserted into the drain, pneumoperitoneu m is established, and the laparoscope is then passed down the cannula and the drain for exploration, The authors considered this technique i n 11 cases and report four cases in which it was used. Therapeutic lap aroscopic procedures-e.g., drainage of collections, adhesiolysis, and stroma formation-were carried out in two cases, and laparotomy was req uired in two. This method is safe, atraumatic, and technically simple, and it can serve diagnostic as well as therapeutic purposes. The simp licity and ease of this method may encourage wider application to bene fit more patients.