Advances in laparoscopic surgery have drastically modified not only th
e thinking of most general surgeons, but have also helped to change th
e approach to many disease processes. The tremendous success of the la
paroscopic approach to biliary tract disease as well as to appendiciti
s, trauma, and even colonic disease led us to consideration and evalua
tion of laparoscopy as a tool in the management of patients with acute
and chronic intestinal obstruction. Forearmed with laparoscopic skill
s gained performing laparoscopic cholecystectomy, common bile duct exp
loration, appendectomy, and laparoscopic colon resection and cognizant
of the many patients with simple adhesions, internal herniae, and vol
vulus, we included all patients with suspected intestinal obstruction
who did not have resolution of signs and symptoms with conservative tr
eatment in this study. Patients were treated initially with intravenou
s fluids, nasogastric suction, and correction of electrolyte disturban
ces. Laparoscopy was performed on 23 patients during the period of May
1991 through April 1993 with resolution of the problem laparoscopical
ly in 20. Details of pathological processes, operations performed, tec
hnique, and guidelines for laparoscopy are included.