Reoperative Crohn's surgery: tricks of the trade

Crohn's disease is a chronic inflammatory disease of the intestinal tract that often results in the need for surgical intervention to treat complications of the disease. The transmural nature of the inflammation can lead to intestinal perforation, intraabdominal abscesses, intestinal strictures, and fistula development. Because there is no cure for Crohn's disease, many patients will require multiple operations during their lifetime. Index surgery and reoperative surgery in these patients is often complex and challenging. There are many preoperative planning and technical aspects of Crohn's surgery that can be helpful in achieving a successful clinical outcome. In this paper, we will review some of the important principles in operative and reoperative Crohn's surgery that can assist the surgeon when approaching these challenging cases.