LAPAROSCOPIC SURGERY IN PATIENTS WITH PREVIOUS SURGERY

This prospective study investigates the technical feasibility and the potential advantage of laparoscopic operative techniques in patients following previous surgery. Data were obtained from a group of patients following previous surgery who underwent laparoscopic cholecystectomy, explorative laparoscopy, laparoscopic adhesiolysis, or laparoscopic procedures on the intestinal tract; all of these patients presented intraabdominal adhesions leading to a change of the originally intended operative procedure. 240 patients who underwent laparoscopic cholecystectomy without previous surgery or with previous surgery but without relevant adhesions represented the control group. End-points of investigation were duration of operation, postoperative hospitalization, intra- and postoperative complications, and postoperative quality of life. A total of 370 patients was followed after laparoscopic procedures. With an equal distribution of complications in both groups a higher percentage of calculated and emergency conversions was found in the group of patients following previous surgery; these conversions did not lead to a larger ratio of complications. The patients' postoperative quality of life, recorded by means of a complaint score, was equal in both groups. These results show that ''previous abdominal surgery'' does not represent a contraindication for laparoscopic surgery and that patients following previous surgery will profit from laparoscopic operations to the same extent as already proven for patients undergoing laparoscopic procedures without previous surgery.