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Laparoscopy and small bowel obstruction in children

Francois Becmeur1

  • 1Department of Pediatric Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France. francois.becmeur@chru-strasbourg.fr

Saudi Medical Journal
|June 5, 2003
PubMed

Insights

Post-operative small bowel obstruction is a costly complication. Laparoscopic surgery can prevent it through careful technique, and laparoscopic treatment is effective in children.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Pediatric Surgery

Background:

  • Post-operative small bowel obstruction (POSBO) is a significant clinical challenge.
  • Adhesions are a primary cause, leading to complications like fistulas and increased mortality.
  • Laparoscopic surgery presents unique risks for small bowel obstruction.

Purpose of the Study:

  • To review known factors contributing to post-operative small bowel obstruction.
  • To identify specific risks and preventative measures for small bowel obstruction after laparoscopy.
  • To evaluate the efficacy of laparoscopic treatment for pediatric small bowel obstruction.

Main Methods:

  • Literature review of post-operative small bowel obstruction.
  • Analysis of laparoscopic trocar site complications and preventative strategies.
  • Multicenter study (GECI) evaluating laparoscopic treatment outcomes in children.

Main Results:

  • Laparoscopic procedures carry a >1% risk of small bowel obstruction via trocar site herniation or other factors.
  • Preventative measures include smaller trocars, fascial repair, careful desufflation, and minimizing surgical debris.
  • Laparoscopic treatment for small bowel obstruction in children yielded good results in two-thirds of cases.

Conclusions:

  • Understanding POSBO risks is crucial for surgical planning and patient outcomes.
  • Adherence to specific techniques can mitigate the risk of small bowel obstruction post-laparoscopy.
  • Laparoscopic intervention is a viable and effective treatment for pediatric small bowel obstruction.

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