Skip to main content


Log in

Laparoscopic management of acute small bowel obstruction

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript



As minimally invasive surgery gains ground, it is entering realms previously considered to be relative contraindications for laparoscopy. We reviewed our experience with the laparoscopic approach to the management of small bowel obstruction (SBO).


From December 1997 to November 2002, 65 patients underwent laparoscopic treatment for SBO. The operating surgeon attempted to identify a transitional point between distended and collapsed bowel and then address the obstruction at that point.


Postoperative adhesions were the cause of the obstruction in 44 patients. Tumor was identified in five cases, hernia in four, bezoar in three, intussusception in three, acute appendicitis and pseudoobstruction in two cases each, and terminal ileitis in one case. The diagnostic accuracy of laparoscopy was 96.9%. Thirty-four patients (52%) were treated by laparoscopy alone. Thirteen patients (20%) required a small target incision for segmental resection. Eighteen operations were converted to formal laparotomy. The mean laparoscopy time was 40 min (range, 25-160). Patients resumed oral intake in 1-3 days. The complication rate was 6.4%. There were two deaths, but none related to laparoscopy. The mean hospital stay was 4.2 days.


Laparoscopy is a useful minimally invasive technique for the management of acute SBO. It is an excellent diagnostic tool and, in most cases, a therapeutic surgical approach in patients with SBO. However, a significant number of patients will require conversion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. F Agresta A Piazza I Michelet N Bedin CA Sartori (2000) ArticleTitleSmall bowel obstruction: laparoscopic approach Surg Endosc 14 154–156 Occurrence Handle10.1007/s004649900089 Occurrence Handle1:STN:280:DC%2BD3c7isVSqtw%3D%3D Occurrence Handle10656950

    Article  CAS  PubMed  Google Scholar 

  2. IS Bailey M Rhodes N O’Rourke L Nathanson G Fielding (1998) ArticleTitleLaparoscopic management of acute small bowel obstruction Br J Surg 85 84–87 Occurrence Handle10.1046/j.1365-2168.1998.00535.x Occurrence Handle1:STN:280:DyaK1c7itl2nsQ%3D%3D Occurrence Handle9462391

    Article  CAS  PubMed  Google Scholar 

  3. DF Bastug SW Trammell JP Boland EP Mantz EH Tiley Suffix3rd (1991) ArticleTitleLaparoscopic adhesiolysis for small bowel obstruction Surg Laparosc Endosc 1 259–262 Occurrence Handle1:STN:280:ByuD1c%2FkvFw%3D Occurrence Handle1669417

    CAS  PubMed  Google Scholar 

  4. JA Caprini JA Arcelus J Swanson R Coats K Hoffman JJ Brosnan S Blattner (1995) ArticleTitleThe ultrasonic localization of abdominal wall adhesions Surg Endosc 9 283–285 Occurrence Handle1:STN:280:ByqA38%2FnsF0%3D Occurrence Handle7597599

    CAS  PubMed  Google Scholar 

  5. D Chosidow H Johanet T Montariol R Kielt C Manceau JP Marmuse G Benhamou (2000) ArticleTitleLaparoscopy for acute small-bowel obstruction secondary to adhesions J Laparoendosc Adv Surg Tech A 10 155–159 Occurrence Handle1:STN:280:DC%2BD3M%2FitVagsQ%3D%3D Occurrence Handle10883993

    CAS  PubMed  Google Scholar 

  6. ME Franklin SuffixJr JP Dorman D Pharand (1994) ArticleTitleLaparoscopic surgery in acute small bowel obstruction Surg Laparosc Endosc 4 289–296 Occurrence Handle7952440

    PubMed  Google Scholar 

  7. CL Garrard RH Clements L Nanney JM Davidson WO Richards (1999) ArticleTitleAdhesion formation is reduced after laparoscopic surgery Surg Endosc 13 10–13 Occurrence Handle10.1007/s004649900887 Occurrence Handle1:STN:280:DyaK1M%2FovVaqsQ%3D%3D Occurrence Handle9869679

    Article  CAS  PubMed  Google Scholar 

  8. IM Ibrahim F Wolodiger B Sussman M Kahn F Silvestri A Sabar (1996) ArticleTitleLaparoscopic management of acute small-bowel obstruction Surg Endosc 10 1012–1014 Occurrence Handle10.1007/s004649900226 Occurrence Handle1:STN:280:ByiD38%2FhsVY%3D Occurrence Handle8864097

    Article  CAS  PubMed  Google Scholar 

  9. EL Leon A Metzger GG Tsiotos RT Schlinkert MG Sarr (1998) ArticleTitleLaparoscopic management of small bowel obstruction: indications and outcome J Gastrointest Surg 2 132–140 Occurrence Handle10.1016/S1091-255X(98)80003-6 Occurrence Handle1:STN:280:DyaK1M%2FlvF2msw%3D%3D Occurrence Handle9834408

    Article  CAS  PubMed  Google Scholar 

  10. H Levard MJ Boudet S Msika JM Molkhou JM Hay Y Laborde M Gillet et al. (2001) ArticleTitleLaparoscopic treatment of acute small bowel obstruction: a multicentre retrospective study Aust N Z J Surg 71 641–646 Occurrence Handle10.1046/j.0004-8682.2001.02222.x Occurrence Handle1:STN:280:DC%2BD3MnovFOksg%3D%3D

    Article  CAS  Google Scholar 

  11. G Miller J Boman I Shrier PH Gordon (2000) ArticleTitleEtiology of small bowel obstruction Am J Surg 180 33–36 Occurrence Handle10.1016/S0002-9610(00)00407-4 Occurrence Handle1:STN:280:DC%2BD3M%2FjsValsw%3D%3D Occurrence Handle11036136

    Article  CAS  PubMed  Google Scholar 

  12. B Navez JM Arimont P Guiot (1998) ArticleTitleLaparoscopic approach in acute small bowel obstruction: a review of 68 patients Hepatogastroenterology 45 2146–2150 Occurrence Handle1:STN:280:DyaK1M7jsFemsQ%3D%3D Occurrence Handle9951882

    CAS  PubMed  Google Scholar 

  13. Y Sato K Ido M Kumagai N Isoda M Hozumi N Nagamine K Ono et al. (2001) ArticleTitleLaparoscopic adhesiolysis for recurrent small bowel obstruction: long-term follow-up Gastrointest Endosc 54 476–479 Occurrence Handle10.1067/mge.2001.117760 Occurrence Handle1:STN:280:DC%2BD3MrjtValtA%3D%3D Occurrence Handle11577310

    Article  CAS  PubMed  Google Scholar 

  14. P Strickland DJ Lourie EA Suddleson JB Blitz SC Stain (1999) ArticleTitleIs laparoscopy safe and effective for treatment of acute small-bowel obstruction? Surg Endosc 13 695–698 Occurrence Handle10.1007/s004649901075 Occurrence Handle1:STN:280:DyaK1Mzhs1equw%3D%3D Occurrence Handle10384077

    Article  CAS  PubMed  Google Scholar 

  15. M Suter P Zermatten N Halkic O Martinet V Bettschart (2000) ArticleTitleLaparoscopic management of mechanical small bowel obstruction: are there predictors of success or failure? Surg Endosc 14 478–483 Occurrence Handle10.1007/s004640000104 Occurrence Handle1:STN:280:DC%2BD3cvitlWgsw%3D%3D Occurrence Handle10858476

    Article  CAS  PubMed  Google Scholar 

  16. C Wullstein E Gross (2003) ArticleTitleLaparoscopic compared with conventional treatment of acute adhesive small bowel obstruction Br J Surg 90 1147–1151 Occurrence Handle10.1002/bjs.4177 Occurrence Handle1:STN:280:DC%2BD3svgsFemtw%3D%3D Occurrence Handle12945085

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to B. Kirshtein.

Additional information

Presented in part at the 10th annual congress of the European Association for Endoscopic Surgery (EAES), Lisbon, Portugal, 2-5 June, 2002

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kirshtein, B., Roy-Shapira, A., Lantsberg, L. et al. Laparoscopic management of acute small bowel obstruction. Surg Endosc 19, 464–467 (2005).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: