LAPAROSCOPIC SURGERY IN PATIENTS WITH PRE VIOUS SURGERY

This prospective study investigates the technical feasibility and the potential advantage of laparoscopic operative techniques in patients f ollowing previous surgery. Data were obtained from a group of patients following previous surgery who underwent laparoscopic cholecystectomy , explorative laparoscopy, laparoscopic adhesiolysis, or laparoscopic procedures on the intestinal tract; all of these patients presented in traabdominal adhesions leading to a change of the originally intended operative procedure. 240 patients who underwent laparoscopic cholecyst ectomy without previous surgery or with previous surgery but without r elevant adhesions represented the control group. End-points of investi gation were duration of operation, postoperative hospitalization, intr a- and postoperative complications, and postoperative quality of life. A total of 370 patients was followed after laparoscopic procedures. W ith an equal distribution of complications in both groups a higher per centage of calculated and emergency conversions was found in the group of patients following previous surgery; these conversions did not lea d to a larger ratio of complications. The patients' postoperative qual ity of life, recorded by means of a complaint score, was equal in both groups. These results show that ''previous abdominal surgery'' does n ot represent a contraindication for laparoscopic surgery and that pati ents following previous surgery will profit from laparoscopic operatio ns to the same extent as already proven for patients undergoing laparo scopic procedures without previous surgery.