The Laparoscopic Approach to Small Bowel Obstruction

Edward L Felix, MD. Clovis Community Medical Center.

In the past the accurate diagnosis and treatment of small bowel obstruction relied on an open exploration of the abdomen. With the advent of minimally invasive techniques, the accuracy of of determining the underlying etiology of the obstruction has been increased while decreasing the morbidity of the procedure. No longer is a large laparotomy incision or smaller misplaced incision necessary. A diagnostic laparoscopy followed by appropriate smultaneous laparoscopic lysis or resection if necessary can be completed totally laparoscopically in simple or complex settings.

This video demonstrates the techniques necessary to treat a variety of small bowel obstructions from simple to complex. The video not only demonstrates the techniques required to complete the procedures laparoscopically, but also demonsrates how the laparoscope can more quicky identify the etiology of the obstruction while decreasing the morbidity of the procedure. In two case the obstruction was not related to the previous primary surgery performed in the upper abdomen and in the final case although a tumor was suspected the exact site was unknow. In all three cases laparoscopy quickly identified the cause of obstruction and location of the obstuction. The treatment was minimized and the hospitalization shortened by utilizing a laparoscopic approach in all three patients.

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