Needle laparoscopy in patients with suspected bowel adhesions

Suspected bowel adhesions are generally considered to be a contraindication to laparoscopy. Among 32 patients who were refused laparoscopy for that reason, only 1 patient was found to have adhesions at laparotomy. To attempt preoperative diagnosis of intraabdominal adhesions, needle laparoscopy was performed in 21 patients using a 1.7-mm endoscope. In 20 of the patients it was possible to establish the presence or absence of adhesions and to determine the feasibility of laparoscopic sterilization. This preliminary evaluation suggests that needle laparoscopy may avert bowel perforation in some instances and may permit laparoscopic tubal sterilization to be performed in some women who would otherwise, because of multiple previous operations, be denied laparoscopy.