[The laparoscopic procedures on abdomen with adhesions]

Area of Science:

• Surgical innovation
• Minimally invasive surgery
• Abdominal surgery

Context:

• Abdominal scars were traditionally a contraindication for laparoscopic surgery.
• Rohr's classification categorizes scar abdomen based on incision type and patient history.
• This study evaluates laparoscopic procedures in patients with prior abdominal surgery.

Purpose:

• To assess the feasibility and safety of laparoscopic surgery in patients with abdominal scars.
• To compare outcomes of laparoscopic procedures in scarred versus non-scarred patients.
• To determine the conversion rate and complications associated with laparoscopic surgery in scar abdomen patients.

Summary:

• A trial of 452 patients with scar abdomen undergoing laparoscopic surgery was conducted.
• Laparoscopic procedures were performed distant to, neighboring, or on the same organ as previous operations.
• The conversion rate was 12%, with complications including visceral injuries, seromas, deep vein thrombosis, and pneumonia.

Impact:

• Laparoscopic surgery is a viable option for patients with abdominal scars.
• Outcomes and hospitalization for scar abdomen patients are comparable to non-operated patients.
• Open laparoscopy facilitates laparoscopic procedures in scar abdomen, with a manageable increase in conversion rates.