Laparoscopic diagnosis and treatment of intestinal obstruction

  • M. E. Franklin Jr
  • J. J. Gonzalez JrEmail author
  • D. B. Miter
  • J. L. Glass
  • D. Paulson
Original article


Background: Intestinal obstruction is a common reason for general surgical referral. The traditional approach has been conservative management, followed by laparotomy if conservative measures are unsuccessful. However, with the advent of minimally invasive surgery, the need for laparotomy for this common problem is being challenged.Methods: From May 1991 to April 2001, 167 patients underwent laparoscopy for diagnosis and/or treatment of intestinal obstruction. Average patient age was 62 years (range, 21–98). The site of obstruction was the stomach in seven patients, small bowel in 116 patients, and colon in 44 patients.Results: Laparoscopy successfully diagnosed the site of obstruction in all patients. In addition, 154 patients (92.2%) were successfully treated laparoscopically without conversion to laparotomy. Both intraoperative and postoperative complication rates were low (3.5 and 18.6%, respectively) and compared favorably with those of published reports.Conclusions: Intestinal obstruction can be approached safely and effectively by laparoscopy with the intent not only to correctly diagnose the patient but also to render treatment.


Small bowel obstruction Laparoscopy Laparoscopic surgery Intestinal obstruction 


  1. 1.
    Adams, S, Wilson, T, Brown, AR 1993Laparoscopic management of acute small bowel obstruction.Aust N Z J Surg633941PubMedGoogle Scholar
  2. 2.
    Agresta, F, Michelet, I, Coluci, G, Bedin, N 2000Emergency laparoscopy: a community hospital experience.Surg Endosc14484487CrossRefPubMedGoogle Scholar
  3. 3.
    Agresta, F, Piazza, A, Michelet, I, Bedin, N, Sartori, CA 2000Small bowel obstruction: laparoscopic approach.Surg Endosc14154156CrossRefPubMedGoogle Scholar
  4. 4.
    Al-Mulhim, AA 2000Laparoscopic management of acute small bowel obstruction: experience from a Saudi teaching hospital.Surg Endosc14157160CrossRefPubMedGoogle Scholar
  5. 5.
    Bailey, IS, Rhodes, M, O’Rourke, N, Nathanson, L, Frielding, G 1998Laparoscopic management of acute small bowel obstruction.Br J Surg858487CrossRefPubMedGoogle Scholar
  6. 6.
    Bryant, TL, Umstot, RK 1996Laparoscopic repair of an incarcerated obturator hernia.Surg Endosc10437CrossRefPubMedGoogle Scholar
  7. 7.
    Cox, MR, Gunn, IF, Eastman, MC, Hunt, RF, Heinz, AW 1993The operative aetiology and types of adhesions causing small bowel obstruction.Aust N Z J Surg63848852PubMedGoogle Scholar
  8. 8.
    Duh, QY, Way, LW 1993Diganostic laparoscopy and laparoscopic cecostomy for colonic pseudo-obstruction.Dis Colon Rectum366570PubMedGoogle Scholar
  9. 9.
    Ehrmantraut, W, Sardi, A 1997Laparoscopy-assisted small bowel resection.Am Surg639961001PubMedGoogle Scholar
  10. 10.
    Ellis, H 1997The clinical significance of adhesions: focus on intestinal obstruction.Eur J Surg Suppl57759PubMedGoogle Scholar
  11. 11.
    Fischer, CP, Doherty, D 2002Laparoscopic approach to small bowel obstruction.Semin Laparosc Surg94045CrossRefPubMedGoogle Scholar
  12. 12.
    Franklin, ME, Dorman, JP, Pharand, D 1994Laparoscopic surgery in acute small bowel obstruction.Surg Laparosc Endosc4289296PubMedGoogle Scholar
  13. 13.
    Franklin, ME, Dorman, JP, Schuessler, WW 1994Laparoscopic treatment of gallstone ileus: a case report and review of the literature.J Laparoendosc Surg4265272PubMedGoogle Scholar
  14. 14.
    Gaddie, D, Serpell, JW 1995Obturation of the small bowel.Aust N Z J Surg65902905PubMedGoogle Scholar
  15. 15.
    Kreutzer, ER, Lerner, SE, Kahan, NZ, Melman, A 1994Laparoscopic treatment of small-bowel obstruction following laparoscopic lymphadenectomy.Urology44768770PubMedGoogle Scholar
  16. 16.
    Larson, GM 1995Laparoscopy for abdominal emergencies.Scand J Gastroenterol306266Google Scholar
  17. 17.
    Loffer, FD, Pent, D 1975Indications, contraindications, and complications of laparoscopy.Obstet Gynecol Surv30407427PubMedGoogle Scholar
  18. 18.
    Navez, B, Arimont, JM, Guiot, P 1998Laparoscopic approach in acute small bowel obstruction. A review of 68 patients.Hepato-Gastroenterology4521462150PubMedGoogle Scholar
  19. 19.
    Paterson-Brown, S, Vipond, MN 1990Modern aids to clinical decision-making in the acute abdomen.Br J Surg771318PubMedGoogle Scholar
  20. 20.
    Reissman, P, Wexner, SD 1995Laparoscopic surgery for intestinal obstruction.Surg Endosc9865868PubMedGoogle Scholar
  21. 21.
    Robles, R, Lujan, JA, Parrilla, P, Torralba, JA, Escamilla, C 1995Laparoscopic surgery in the treatment of small bowel obstruction by bezoar.Br J Surg82520PubMedGoogle Scholar
  22. 22.
    Rosin, D, Kuriansky, J, Bar Zakai, B, Shabtai, M, Ayalon, A 2000Laparoscopic approach to small-bowel obstruction.J Laparoendosc Adv Surg Tech10253257Google Scholar
  23. 23.
    Sanders, LE 1995Laparoscopic treatment of Meckel’s diverticulum: obstruction and bleeding managed with minimal morbidity.Surg Endosc9724727PubMedGoogle Scholar
  24. 24.
    Strickland, P, Lourie, DL, Suddleson, EA, Blitz, JB, Stain, SC 1999Is laparoscopy safe and effective for treatment of acute small-bowel obstruction?.Surg Endosc13695698CrossRefPubMedGoogle Scholar
  25. 25.
    Suter, M, Zermatten, P, Halkic, N, Martinet, O, Bettschart, V 2000Laparoscopic management of mechanical small bowel obstruction: are there predictors of success and failure?.Surg Endosc14478483CrossRefPubMedGoogle Scholar
  26. 26.
    van der Zee, DC, Bax, NMA 1999Management of adhesive bowel obstruction in children is changed by laparoscopy.Surg Endosc13925927CrossRefPubMedGoogle Scholar
  27. 27.
    Wilson, MS, Ellis, H, Menzies, D, Moran, BJ, Parker, MC, Thompson, JN 1999A review of the management of small bowel obstruction.Ann R Coll Surg England81320328Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • M. E. Franklin Jr
    • 1
  • J. J. Gonzalez Jr
    • 1
    Email author
  • D. B. Miter
    • 1
  • J. L. Glass
    • 1
  • D. Paulson
    • 1
  1. 1.Texas Endosurgery Institute, 4242 E. Southcross, Suite 1, San Antonio, TX 78222USA

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