Shorter postoperative atony after laparoscopic-assisted colonic resection?An animal study

Background: The duration of the postoperative ileus after laparoscopic surg ery remains a controversial topic. The aim of our study was to compare the restoration of intestinal motility after laparoscopically assisted and conv entional resection of the distal colon in a canine model. Methods: Two weeks after the implantation of three electrodes on the jejunu m, the distal colon was resected in a laparoscopic-assisted or conventional procedure in two groups of four dogs each. Gastrointestinal motility was m onitored by registration of the electromyograhic activity of the small inte stine and by intermittent fluoroscopies of radiopaque markers. Results: Electrical activity in the early postoperative period was characte rized by the basic electrical rhythm and the absence of spike activity. The first postoperative activity front of the migrating motility complex (MMC) , indicating the restoration of motility, occurred significantly earlier af ter laparoscopic-assisted resection (4.5 +/- 1 hr) than after conventional resection (31 +/- 10 h). Radiological observations showed a significantly d elayed gastric emptying and a prolonged transit of radiopaque markers to th e rectum after open surgery. Conclusion: These results support the hypothesis that laparoscopic-assisted resection of the colon leads to a shortened postoperative atony in compari son to open surgery.