Laparoscopic diagnosis and treatment of intestinal obstruction.
BACKGROUND
Intestinal obstruction is a common reason for general surgical referral. The traditional approach has been conservative management, followed by laparotomy if conservative measures are unsuccessful. However, with the advent of minimally invasive surgery, the need for laparotomy for this common problem is being challenged.


METHODS
From May 1991 to April 2001, 167 patients underwent laparoscopy for diagnosis and/or treatment of intestinal obstruction. Average patient age was 62 years (range, 21-98). The site of obstruction was the stomach in seven patients, small bowel in 116 patients, and colon in 44 patients.


RESULTS
Laparoscopy successfully diagnosed the site of obstruction in all patients. In addition, 154 patients (92.2%) were successfully treated laparoscopically without conversion to laparotomy. Both intraoperative and postoperative complication rates were low (3.5 and 18.6%, respectively) and compared favorably with those of published reports.


CONCLUSIONS
Intestinal obstruction can be approached safely and effectively by laparoscopy with the intent not only to correctly diagnose the patient but also to render treatment.
Franklin
M E
ME
Texas Endosurgery Institute, 4242 E. Southcross, Suite 1, San Antonio, TX 78222, USA.
Gonzalez
J J
JJ
Miter
D B
DB
Glass
J L
JL
Paulson
D
D
D000047:Academies and Institutes / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D006547:Hernia / Q000150:complications / Q000175:diagnosis; D059685:Herniorrhaphy; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011446:Prospective Studies; D013781:Texas; D000267:Tissue Adhesions / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome