(Introduction) To construct a more effective operation for adhesive bowel obstruction, we introduced laparoscopic surgery and bioabsorbable membrane for operation of this disease. Recurrent adhesive bowel obstruction is supposed to be indication of operation. But it is undeniable that the new adhesion between damaged peritoneal areas and bowels may be constructed. Recently, efficacy of laparoscopic surgery or hyaluronate-carboxymethylcellulose membrane (Seprafilm) in operation of adhesive bowel obstruction have been reported frequently. We introduced a new procedure using laparoscopic surgery and Seprafilm on operation of adhesive bowel obstruction. This procedure has been satisfactory in the short-term result, then we would like to report it.
(Methods and procedure) We introduced laparoscopic surgery on operation of recurrent adhesive bowel obstruction two years ago. Simple adhesion cases were performed adhesiolysis under laparoscopic view. At cases of innvolved mass of adherent bowel, we exteriorize it from minilaparotomy (3~4cm) and performed bowel resection outside of the body (Laparoscope-assisted surgery). We have performed Laparoscopic adhesiolysis or laparoscope-assisted bowel resection for 6 cases. At last 3cases, we introduced new procedure. At the end of operation, we applied Seprafilm directly to damaged parietal peritoneum under laparoscopic view. Using this procedure, we can locate interposing barrier to correct lesiondespiteresumed peristaltic motion. (results) We have performed 6 cases of laparoscopic or laparoscope-assisted operation. The mean operation time was 145 minute, and the mean blood loss was 83 mL. All patents have been asymptomatic after the operation at leastfor a year. (conclusion) We have performed Laparoscopic or laparoscope-assisted adhesive bowel obstruction operation on 6 cases. At last 3 cases, we applied Seprafilm directly to damaged parietal peritoneum under laparoscopic view. This procedure has been satisfactory in the short-term result. Increase of cases and long-term results are expected to this procedure.
Program Number: P112