Laparoscopic adhesiolysis for small bowel obstruction.
BACKGROUND
Historically, laparotomy and open adhesiolysis have been the treatment for patients requiring surgery for small bowel obstruction. Laparoscopic adhesiolysis has not gained wide acceptance. The indications and outcomes of laparoscopic adhesiolysis for small bowel obstruction are not well established. The purpose of this paper is to review the literature on laparoscopic adhesiolysis for small bowel obstruction and to discuss patient selection, surgical technique, and outcomes.


METHODS
Medline search from 1980 to 2002.


CONCLUSIONS
Laparoscopic adhesiolysis has been shown to be safe and feasible in experienced hands. For selected patients, laparoscopic adhesiolysis offers the advantages of decreased length of stay, faster return to full activity, and decreased morbidity. Patient selection and surgical judgment appear to be the most important factors for a successful outcome.
Nagle
Alexander
A
Department of Surgery, Northwestern University, Feinberg School of Medicine, 201 E. Huron St., Galter 10-105, Chicago, IL 60611, USA.
Ujiki
Michael
M
Denham
Woody
W
Murayama
Kenric
K
D000465:Algorithms; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small; D007432:Intraoperative Period; D010535:Laparoscopy; D000267:Tissue Adhesions / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome