Single-incision laparoscopic-assisted surgery for small bowel obstruction.

Background: Acute small bowel obstruction (SBO) is a common cause of emergency hospital admission, often requiring surgical intervention. Herein, we describe the single-incision laparoscopic surgery (SILS) procedure for the management of SBO in the acute care setting.

Patients And Methods: Patients with intestinal obstruction who underwent SILS in Chang Gung Memorial Hospital, Linkou, Taiwan, from January 2010 to January 2012 were retrospectively analyzed. Informed consent was obtained from all patients. Demographic information, intraoperative findings, surgery duration, and conversion to multi-incision laparoscopic surgery (MILS) were recorded. Postoperative records included the recovery period after surgery, complications, length of hospital stay, and final prognosis.

Results: Ten SILS procedures for the repair of SBO were performed (six women, four men; median age, 52 years [range, 28-89 years]). Only 1 patient (10%) required conversion to MILS. The median operative time was 140 minutes (range, 90-210 minutes), median time to resume oral intake was 3 days (range, 1-7 days), median time to ambulation was 3 days (range, 1-6 days), and median postoperative hospital stay was 7.5 days (range, 3-14 days). There was no mortality in this series. All patients were discharged uneventfully. The umbilical incision was nearly invisible at the 1-month follow-up. The median follow-up time was 13.5 months (range, 4-26 months). No incisional hernias or adhesions were observed.

Conclusions: SILS for SBO is a feasible, safe procedure that can be performed as initial treatment in select patients with bowel obstruction through resection and decompression of the small bowel using intra- or extracorporeal techniques, resulting in a nearly invisible scar.