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LAPAROSCOPIC MANAGEMENT OF SMALL BOWEL OBSTRUCTION

Prof Subhash Khanna, MS, FICS, FIAGES, FALS. Swagat Super Speciality Surgical Institute

BACKGROUND: Acute abdomen is one of the commonest presenting  symptom to an emergency physician and surgeon In the day to day clinical practice.

Acute abdominal may be caused by various causes but small bowel obstruction is one of the common causes of those patients particularly   having history of previous surgery

Although considered a relative contraindication diagnostic laparoscopy is increasingly being used in small bowel obstruction not only for diagnosis but also as a therapeutic tool.

We had been using diagnostic laparoscopy in all our cases of bowel obstruction presenting to us

particularly  those patients who did not have massive distension and who were not in shock.

With growing experience small bowel obstruction is no more a contraindication to diagnostic laparoscopy rather most of these cases can be better managed with laparoscopy compared to convention surgery.

METHODS: We searched medical records of medical records of all patients of acute abdomen undergoing diagnostic laparoscopy in our both centers during the period from august 2000 to june 2018 and reviewed the medical records of all the patients were reviewed to obtain data on feasibility, intra operative findings and also the total number of cases who needed a small incision for segmental resection or enterotomy.

We shall be presenting our data of all cases of bowel obstruction presenting to us and shall also share the technique of release of obstruction with video clippings of internal hernias, band obstruction, obstruction due to Meckel’s and many such rare conditions including trichobezoar.

CONCLUSION:  Diagnostic laparoscopy should always remain a preferred option in patients presenting with small bowel obstruction particularly those without massive abdominal distension as many of these patients can be better managed by laparoscopy  much better way compared to unnecessary laparotomy causing morbidity. We shall present our series and some of the rare cases presented to us and who underwent therapeutic laparoscopic management successfully.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95877

Program Number: P039

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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