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The laparoscopic second look for ischemic bowel disease
S Slutzki1, Z Halpern, M Negri
1Department of Surgery "B," Assaf Harofeh Medical Center, Affiliated to Sackler Faculty of Medicine,
Background:
Survival after acute vascular ischemia depends on a second look laparotomy to detect extending bowel compromise and to verify the integrity of the anastomosis. In a series of five consecutive patients with acute ischemic bowel disease, we used laparoscopic technique to determine if a formal laparotomy could be avoided.
Methods:
following the resection of ischemic bowel in five consecutive patients, two laparoscopic trocars were inserted in the lower abdominal quadrants and covered by sterile gloves. Forty-eight to 72 h following the primary operation, the abdomen was inflated via a trocar and secondary assessment done by laparoscopy.
Results:
In all patients, the integrity of the anastomosis and viability of the remaining bowel was accurately assessed by laparoscopy.
Conclusions:
Using minimally invasive techniques, a second look laparotomy was avoided in 5 patients with ischemic bowel disease.