Management of laparoscopic-related bowel injuries

Background: Bowel injury is an uncommon but severely hazardous complication of various laparoscopic procedures. Methods. Twelve cases of bowel injuries complicating different laparoscopic procedures were diagnosed or received at Ain Shams University and Menofia University hospitals over the last 3 years. The mechanism of injury was ana lyzed, the diagnostic methods and surgical management scrutinized, and the prognosis studied. Results: The injuries were attributed to the inadvertant introduction of Ve ress needles or sharp-tipped trocars or forcible undue dissection. Failure of pneumoperitoneum was implicated in two cases. Faulty judgment of the ext ent and site of adhesions contributed to the damage in two cases. In four c ases, the duodenum was injured. The colon was perforated in six cases, and the small bowel sustained damage in two cases. Three of the patients died, all of duodenal injury. The other nine patients survived by virtue of diagn osis and proper operative management. Conclusion. Every measure should be taken to avoid the occurrence of bowel injury during laparoscopy. Intraoperative or early postoperative diagnosis and proper management of laparoscopic-induced bowel injuries can minimize m orbidity and mortality and yield a better prognosis.