The Laparoscopic Approach of Small Bowel Obstruction - The Experience of a Primary Center

Introduction: Small bowel obstruction represents up to 16% of surgical emergencies. Mortality and morbidity depend on early recognition, correct diagnosis and timely surgical management. The most frequent causes of small bowel obstruction are adhesions, malignant tumors, hernias and volvulus. Although laparoscopic surgery is not promoted for the management of small bowel obstruction, it may address many of the mentioned causes. In the same time, it represents a useful diagnostic tool that does not affect the integrity of the abdominal wall. Materials and Methods: The current study resumes the experience of a medium volume primary center. Between March 2010 and October 2015, 38 patients were diagnosed with small bowel obstruction and suffered laparoscopic interventions. In 7 cases conversion to open surgery was necessary. Results: Mortality was 0% and specific morbidity was 12%. The mean operating time was 87.2 minutes with wide variations depending on etiology and the mean postoperative hospital stay was 4.7 days. Conclusion: The laparoscopic approach of small bowel disease is feasible and safe in selected cases and offers evident benefits regarding to the integrity of the abdominal wall, rapid return of bowel function and shorter hospital stay.