THE ROLE OF LAPAROSCOPY IN THE MANAGEMENT OF ACUTE BOWEL OBSTRUCTION

Aim: Adhesions are a common sequela after abdominal surgery. Adhesions are an important etiology of acute or chronic intestinal obstruction. The aim of this prospective clinical trial study is to evaluate the use of laparoscopy in management of clinically diagnosed adhesive intestinal obstruction Methods: Fifty six patients with adhesive small bowel obstruction underwent laparoscopic adhesiolysis between April 2008 to April 2100 in Suez Canal University Hospital. Results: Laparoscopic adhesiolysis was done to 40 men and 16 women, with a mean age of 43.5 years. Thirty six patients had one and 18 patients had two prior abdominal or pelvic operations. The types of adhesions were identified laparoscopically in all patients: isolated bands were found in 13 patients, enteroperitoneal angulation, in 14; entero-enteral angulation, in 19; and extensive dense and matted intraabdominal adhesions, in 10 patients. Fifty two patients (92.9%) were successfully treated laparoscopically; Conversion was required in 4 cases (7.14%). The mean procedural time was 60 minutes in laparoscopic procedure and 82 minutes in laparotomy. Intestinal serosal injury occurred during laparoscopic adhesiolysis in 3 patients (5.4%) that were successfully repaired laparoscopically by ser-serous suturing. Two patients underwent laparotomy had had wound infection that responded well to antibiotic, There was no mortality. Conclusion: Laparoscopic adhesiolysis is the preferred approach for treating adhesive small intestinal obstruction