Michael E Dolberg, MD, Jeffrey P Snow, MD. Memorial Healthcare System
Purpose: This video describes a case of a 79 year old female with a history of a prior hysterectomy who presented to the hospital with abdominal pain. A CT scan of the abdomen and pelvis was suspicious for a closed loop small bowel obstruction. She was taken to the operating room for a laparoscopic exploration.
Methods: Laparoscopic exploration revealed a closed loop bowel obstruction with ischemic small intestine and necrotic mesentery. A laparoscopic bowel resection was performed. An intra-corporeal fully stapled anastomosis was utilized to treat her pathology.
Results: This patient was successfully treated using a minimally invasive technique in the emergent setting. Performing an intra-corporeal anastomosis allowed for the use of only laparoscopic incisions – including specimen extraction. She had a fast return of bowel function and was discharged on post-operative day 3.
Conclusions: Laparoscopy is a useful tool in the treatment of small bowel obstructions. Although obstructions with associated necrosis present a technical challenge, minimally invasive techniques can be utilized safely. Intra-corporeal small bowel anastomoses can be performed with small incisions. This leads to improved patient outcomes including less pain, faster return of bowel function, and decreased length of hospitalization.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79440
Program Number: V105
Presentation Session: Acute Care Surgery
Presentation Type: Video
sages_adbutler_leaderboard