Laparoscopic adhesiolysis - results following prospective surveillance

Introduction: About 90% of the patients have abdominal surgery develop adhe sions afterward. Studies analyzing complications and follow-up even in emer gency cases are rare. Methods: Intra- and postoperative findings and compli cations and follow-up were analyzed in a prospective trial between January 1994 and June 1998. Results: We performed laparoscopic procedures in 56 pat ients with complaints of obstructing adhesive bands or adhesions. Ninety-si x percent of the patients have had abdominal surgery; 51.8% were treated as emergency cases with acute pain, 48.2% with chronic abdominal pain. Intrao peratively, 37.5% of the patients showed single adhesive bands; 62.5% showe d adhesions. Mean operation time was 60 min, conversion rate: 5.4%. Complic ations were recorded according to the "Cologne classification"': class I: 7 8.6%, class II: 8.9%, class III: 1.8%, class IV: 10.8%, class V: 0%. The po stoperative hospital stay was 6 days on average. Conclusion: Our study sugg ests that laparoscopic adhesiolysis can be done safely in emergency cases a nd in patients with extensive adhesions as well.