Laparoscopic Management of Small Bowel Obstruction with a Single Transition Point in a ‘Virgin’ Abdomen”: Cohort Study

Rajput K*, Patel R and Kalaiselvan R

St Helens and Knowsley NHS Foundation Trust, UK

^*Correspondance to: Kunal Rajput 

 PDF  Full Text DOI: 10.25107/2474-1647.3401

Abstract

Introduction: Congenital Band Adhesions (CBA) are fibrous bands that may present as Small Bowel Obstruction (SBO) to the emergency general surgical department. They occur exclusively in patients who have never undergone abdominal surgery. Laparoscopic approach to the management of SBO is gaining precedence. We report our experience of laparoscopic division of CBA causing SBO. Method: Data was collected retrospectively from a prospectively maintained logbook of emergency cases performed over a 17-month period (January 2020 to May 2021) to identify emergency operations performed for CBA. Patients that underwent laparoscopic repair of CBA, with no previous abdominal surgeries were included. Patients were routinely followed up in an outpatient telephone clinic. Results: Nine cases were included in the study, with a median age of 77 (range 63 to 82 range). One operation was converted to laparotomy due to small bowel perforation requiring resection. All patients underwent a pre-operative Computed Tomography (CT). Additionally, all band adhesions were found to cause obstruction at distal ileum. The median length of operation was 70 min (range 55 to 95 range). Median length of inpatient stay was 5 days. There were no mortalities, nor were there any complications on follow up. Patients reported returning to normal daily activity at a median time of 8.5 days (range 0 to 42 days). Five patients denied experiencing pain post-operatively. Conclusion: Early diagnosis by CT scan is imperative to achieve favourable surgical outcomes. Our study has demonstrated the safety and efficacy of early laparoscopic division of band adhesions.

Keywords

Laparoscopy; Congenital band adhesions; Bowel obstruction

Cite the article

Rajput K, Patel R, Kalaiselvan R. Laparoscopic Management of Small Bowel Obstruction with a Single Transition Point in a ‘Virgin’ Abdomen”: Cohort Study. Clin Surg. 2022; 7: 3401..