Laparoscopic adhesiolysis for recurrent small bowel obstruction: long-termfollow-up

Background. Recurrent small bowel obstruction caused by postoperative adhes ions has traditionally been treated by conventional laparotomy, but laparos copic management of acute small bowel obstruction has been reported. The ai m of this study was to assess the long-term efficacy and clinical outcome o f laparoscopic adhesiolysis for recurrent small bowel obstruction. Methods: After conservative treatment, elective laparoscopic treatment was attempted In 17 patients hospitalized for recurrent small bowel obstruction after abdominal or pelvic surgery. Results: Postoperative adhesions were identified laparoscopically in all pa tients. Laparoscopic treatment was possible in 14 patients (82.4%). Convers ion to laparotomy was required for 3 patients (17.6%) because of intestinal perforation (n = 1) or a convoluted mass of adherent bowel (n = 2). Long-t erm follow-up was possible in 16 patients. Two recurrences of small bowel o bstructions were noted over a mean follow-up period of 61.7 months. Conclusions: Laparoscopic adhesiolysis is a safe and effective treatment fo r recurrent small bowel obstruction. Conversion to laparotomy should be con sidered in patients with dense adhesions.