Fernando Arias, MD, FACS1, Gabriel Herrera, MD1, Manuel Arrieta, MD2. 1University Hospital Fundacion Santa Fe de Bogota – University of the Andes, Bogota, Colombia, 2University Of Sabana, Colombia
Introduction: Laparoscopic surgery for small bowel obstruction have been accepted in guidelines. Reports indicates minimal invasive surgery results in less adhesion formation, less postoperative pain and shorter hospital stay. However, this approach has technical issues because small bowel dilatation can limitate operative space, which can lead to a higher risk of iatrogenic bowel injury. Althought, the role of single port laparoscopic surgery remains unclear, in this case report we managed closed loop bowel obstruction managed single port laparoscopic surgery and intestinal resection.
Methods: We present a 25 years old male with a history of annular pancreas with multiples procedures for correction in childhood and an open appendectomy 3 years ago. He presented to the emergency department with a 3 days history of general abdominal pain associated with nausea, vomiting and obstipation. Patient referred 2 similar episodes in the past. Abdominal CT showed a high grade obstruction with a transition point between small bowel segments. Informed consent was obtained and (patient) he was scheduled for surgery.
Results: We performed a single port laparoscopic founding a closed loop bowel obstruction with a necrotic segment due to a severe adhesions syndrome. Patient required complete adhesiolysis and resection of 40 cm of small bowel with a side by side anastomosis. The surgical time was 135 min and bleeding about 50 cc. On postoperative day 3, the patient tolerated food and on day 5 was discharged. Follow up to 20 months with no new episodes of small bowel obstructions.
Conclusions: Minimal invasive management is still controversy for the management of small bowel obstruction, however, it can be used safely despite the number of adhesions founded, obtaining excellent outcomes in selected patients when is performed by an experienced surgeon.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95586
Program Number: P453
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster