LAPAROSCOPIC SURGERY IN ACUTE SMALL-BOWEL OBSTRUCTION

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.