Purpose: Postoperative intestinal obstruction has previously been regarded as a contraindication for laparoscopy due to the risk of iatrogenic bowel injury and the technical difficulties. Yet the development of laparoscopic technique and the expansion of surgeons' experience have introduced new consideration for performing laproscopy for managing postoperative bowel obstruction. The aims of this study were to assess the feasibility and the safety of the laparoscopic approach (LA) for treating postoperative intestinal obstruction. Methods: We conducted a retrospective chart review of all the patients (the patients' characteristics, the reasons for open conversion, the postoperative outcomes, the postoperative complications etc.) who were operated on for postoperative small bowel obstruction from Jan 2000 to Feb 2007 at Dong-A University College of Medicine. Results: Laparoscopy was performed in 15 patients and a complete LA was performed in 11 patients (73.3%). Eighteen patients were treated with conventional laparotomies. The mean operation time for the laparoscopic approach and laparotomy was 117.3 and 130.5 minutes, respectively (p=0.5068). Bowel movement started 2.6 days after operation for the laparoscopic group (LG) (Conventional laparotomy group (CLG): 5.4 days) (p=0.0299). Early clear liquid diet intake was possible in the LG group (postoperative 4.8 days)(CLG: 7.9 days). Less postoperative pain control was needed in the LG (4.4 days) than that for the laparotomy group (6.8) (p=0.0034). The mean length of the hospital stay was 8.3 and 19 days, respectively (p=0.0438). Postoperative complications occurred in 2 patients in the LG group and in 7 patients in the conventional laparotomy group (CLG) (p=0.0328). Conclusion: The LA for the treatment of small bowel obstruction seems to be safe and feasible in selected cases. Further prospective randomized trials between LA and laparotomy are required to validate the merits of the LA for treating small bowel obstruction.

Keywords: Laparoscopy, Adhesions, Small bowel obstruction