LAPAROSCOPIC-ASSISTED BOWEL SURGERY

The use of laparoscopic surgical techniques is now being applied to a variety of operations traditionally performed in an open fashion. Twen ty patients underwent laparoscopic-guided large and small bowel surger y at our institution from March 1991 to April 1992. The indications fo r surgery included polyps, obstruction, bleeding, and perforation, and pathologic diagnoses included benign polyps, lipomas, inflammatory bo wel discase, perforation of a jejunal diverticulum, colonic arterioven ous malformations, and adenocarcinoma. Mobilization of the colon, liga tion of the mesentery, and closure of the mesenteric defect were perfo rmed using the laparoscopic equipment. One trocar site was enlarged to 3 cm to deliver the bowel through the abdominal wall. All anastomoses were hand-sewn. Postoperative hospitalization ranged from 2 to 31 day s (median, five days). No mortality, was noted, and morbidity was 20 p ercent. We conclude that laparoscopic-guided bowel surgery is technica lly feasible and should translate into shorter hospitalization and les s patient discomfort.