Laparoscopic abdominal observation method without anesthesia for preventing unnecessary second-look procedures: Short report

Second-look operations after massive intestinal resections secondary to mes enterovascular occlusion are a frequent practice. In about one half of pati ents who undergo second-look procedures, no intraabdominal intervention is necessary. We present a laparoscopic abdominal observation method to preven t unnecessary laparotomies. In the first operation, two laparoscopic trocar s, 5 and 10 mm in diameter, were left in the abdominal wall. After an appro priate time interval, the abdomen was explored laparoscopically through the se trocars without anesthesia. If obvious intestinal gangrene and anastomot ic leaks were observed laparoscopically, the patients were reoperated on wh ile under general anesthesia; otherwise, the procedure was terminated with removal of the trocars. This method was performed on six patients. Unnecess ary relaparotomies were prevented in four patients; intestinal gangrene and anastomotic leaks were not missed in the remaining two patients. A larger patient sample is needed to assess the advantages of this method in prevent ing unnecessary laparotomies.