World Journal of Laparoscopic Surgery

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VOLUME 3 , ISSUE 1 ( January-April, 2010 ) > List of Articles

RESEARCH ARTICLE

Comparative Study of Postoperative Adhesions by Laparotomy and Laparoscopic Procedures

Rama Hegde

Citation Information : Hegde R. Comparative Study of Postoperative Adhesions by Laparotomy and Laparoscopic Procedures. World J Lap Surg 2010; 3 (1):31-36.

DOI: 10.5005/jp-journals-10007-1078

Published Online: 01-04-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background

Abdominal operations result in random and unpredictable adhesion formation. Postoperative adhesion may contribute to recurrent episodes of small bowel obstruction, chronic pain abdomen or both. Laparotomy and laparoscopy are the modes used to treat the adhesion related complications.

Aims and objectives

(1) To study the adhesion related complications and treat the same by means of laparotomy and laparoscopic procedures. (2) To study how the risk of postoperative adhesions can be minimized.

Materials and methods

About 50 cases from March 2007 to February 2009 were studied in Government hospital, Sirsi, Karnataka, India. Patients who underwent some surgical procedures before presenting with adhesions related complications like small bowel obstruction and chronic pain abdomen were considered. Patients who required intervention were treated with surgical procedures. Patients who presented with obstructive features underwent laparotomy and who presented with chronic pain abdomen underwent laparoscopy.

Results

All the 50 patients who were in our study had undergone some conventional surgeries in previous instance. No patient in our study had undergone laparoscopy in previous instance. Appendicectomy (40%), lower segment cesarean section (22%) were the common surgeries which resulted in adhesions. Thirty-four patients in our study presented with obstructive features, underwent laparotomy and adhesiolysis. Sixteen patients in our study underwent laparoscopy for chronic pain abdomen. Both surgeries were safe and resulted in recovery of almost all patients. We could not follow-up most of the patients after 3 months so the outcome of adhesiolysis by both procedures is not known.

Conclusion

(1) Conventional surgeries leads to more adhesion formation than the minimal invasive procedures. (2) Appendicectomy and pelvic surgeries are the common cause of adhesions. (3) Both laparotomy and laparoscopy can be safely used as mode of treatment of adhesion related complications. (4) Operative treatment of acute abdomen by laparoscopy can be recommended.


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