Extensive laparoscopic adhesiolysis: benefits and risks

Abstract

Introduction. The continuous process of broadening the indications of laparoscopy has determined a reevaluation of its risks and benefits in extensive adhesiolysis. The objective of the study. The aim of the present study was to evaluate the efficacy and the associated risks of the laparoscopic adhesiolysis in the surgical management of the intestinal obstruction secondary to postoperative peritoneal adhesions. Material and methods. 17 patients with intestinal obstruction secondary to postoperative peritoneal adhesions admitted to the Surgical Department of the “Sf. Pantelimon” Emergency Hospital from Bucharest, Romania, between January 2014 and January 2018, were treated using laparoscopic surgery. The pneumoperitoneum was made using the open technique, far from the skin scars secondary to previous surgical interventions. After identifying the postoperative peritoneal adhesions as the cause of intestinal obstruction, the entire peritoneal cavity was rigorously inspected. Results. The laparoscopic exploration of the peritoneal cavity allowed for a clear identification of the cause and the level of the intestinal obstruction for all 17 patients included in the present study, 14 of them being treated by simple laparoscopic adhesiolysis, in 3 cases the conversion to laparotomy being necessary. The morbidity rate was low with no cases of death. The mean hospitalization stay was 5 days. Conclusions. The laparoscopic surgery represents an efficient therapeutic alternative to the classical methods for the treatment of the intestinal obstruction secondary to postoperative peritoneal adhesions, constituting a diagnostic and therapeutic tool that has the benefits of the minimally invasive techniques.

Keywords

• laparoscopy
• adhesiolysis
• benefits
• risks