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  • Title: Second-look laparoscopy after laparoscopic relief of strangulated small bowel obstruction.
    Author: Pearl JP, Rosen MJ.
    Journal: Surg Laparosc Endosc Percutan Tech; 2009 Jun; 19(3):241-3. PubMed ID: 19542854.
    Abstract:
    Laparoscopy is increasingly used for the treatment of complex small bowel obstructions (SBO). Conventional treatment of strangulated bowel is segmental resection. We have used second-look laparoscopy to preserve bowel in 4 cases of strangulated SBO. Of the 17 patients with bowel obstruction treated laparoscopically 4 had ischemic bowel. The obstructions were relieved and second-look laparoscopy was performed 24 hours later. In 3 cases the bowel had largely regained its normal appearance; 1 case required resection based on persistent ischemia. An average of 20 cm of bowel was preserved per patient, and there were no complications in these 4 patients. In sum, we have shown second-look laparoscopy for strangulated SBO to be feasible, safe, and, in most cases, bowel conserving.
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