Acute small bowel obstruction two months after laparoscopic rectal prolapse surgery: laparoscopic management
Epublication WebSurg.com, Apr 2013;13(04). URL: http://websurg.com/doi/vd01en3899
Acute small bowel obstruction (SBO) is an ever-increasing clinical problem. In this video, the authors demonstrate the laparoscopic management of acute small bowel obstruction. Its successful management depends on a comprehensive knowledge of the etiology and pathophysiology of obstruction, familiarity with imaging methods, good clinical judgment, and sound technical skills. The adoption of laparoscopy in the treatment of SBO has been slow because of concerns for iatrogenic bowel injury and working space issues related to bowel distension. In this film, the authors demonstrate that it is essential to rapidly manage the patient after the first acute attack. Although there is an inherent appeal for laparoscopy in its potential to minimize short- and long-term wound complications and perioperative laparotomy-related morbidity and to theoretically induce fewer subsequent adhesions than a traditional laparotomy incision would. Small bowel obstruction is a pathology commonly found in the current practice of surgical emergencies. The main cause stems from surgical history with a variable onset of symptoms. The introduction of laparoscopic surgery helped to slightly reduce the number of patients presenting with occlusive syndromes. The rapid management of occlusive patients is one of the keys to success. Consequently, once diagnosis has been evoked, imaging studies must be performed, and especially CT-scan, in order to determine the type of obstruction, its mechanism and its severity. After work-up, either a conservative medical treatment or surgery will be decided upon.