Publication:

Laparoscopic approach for small - bowel perforation -early outcome for 20 patients

Background Small bowel perforation is still a major health problem in the developing world with its attendant high morbidity and mortality. Till date Small bowel perforation has been treated by conventional laparotomy. Early surgery has become the accepted mode of treatment and this has improved survival in the patients. Reports are now available for the feasibility of laparoscopic repair of Small bowel perforation. Laparoscopy provides diagnostic as well as therapeutic capabilities with diagnostic accuracy reaching 100%. The objective of the study was to to study benefit of laparoscopic approach for small bowel perforation.

Methods We selected 20 patients who presented with the small bowel perforation from May 2009 to November 2011. All patients were haemodynamically stable and presented within 48 hours treated by Laparoscopic approach. Results were analyzed in terms of wound infection, hospital stay, return to work, and mortality.

Results There was no conversion. Perforations treated with intracorporeal suturing in 11 patients and laparoscopic assisted extracorporeal suturing in 9 patients. Laparoscopy reduces postoperative pain, wound infections, hospitalization, and early recovery. There was no chest infection, post-operative intra-abdominal collection and mortality.

Conclusions Laparoscopy is an effective tool in avoiding negative and non-therapeutic laparotomy and offered profound therapeutic potential laparoscopic approach is safe, reliable and feasible, required shorter operative time, lesser analgesia, fewer complications, shorter hospital stay and early recovery.