Daniel Gómez, Department of Advanced Laparoscopic Surgery, Centro Policlínico Olaya, Bogotá, Colombia Luis F. Cabrera-Vargas, Departamento de Cirugía General, Universidad El Bosque, Bogotá, Colombia Mauricio Pedraza, Department of General Surgery, Cobos Medical Center, Bogotá, Colombia Andres Mendoza, Department of General Surgery, Cobos Medical Center, Bogotá, Colombia Jean A. Pulido-Segura, Department of General Surgery, Cobos Medical Center, Bogotá, Colombia Ricardo Villarreal-Viana, Department of General Surgery, Cobos Medical Center, Bogotá, Colombia Andres Urrutia, Department of General Surgery, Cobos Medical Center, Bogotá, Colombia Sebastian Sanchez-Ussa, Department of General Surgery, Cobos Medical Center, Bogotá, Colombia Salomone Di Saverio, Emergency and Trauma Surgery Unit, Maggiore Hospital Regional Emergency Surgery and Trauma Center-Bologna Local Health District, Bologna, Italy


Aim of the study: Laparoscopic adhesiolysis in small bowel obstruction (SBO) is getting increasingly normal. In patients with multiple adhesive SBOs (MASBO), laparoscopic approaches might increase the risk of bowel injury due to the distended and potentially compromised small bowel. It remains a challenge to the surgeons, entails an interdisciplinary team, trying to achieve the least complications as possible. The study aimed to compare surgical outcomes of laparoscopic procedures (multi-port vs. single-port) in the management of MASBO. Patients and Methods: Comparative study of 68 patients with post-operative MASBO treated with Single-Port single incision laparoscopic surgery (SILS) and Multi-port Laparoscopic Surgery in two centers of Bogota, Colombia between January 2013 and June 2018. Results: All patients underwent laparoscopic management, 27 patients by SILS, and 41 patients by multi-port. The average surgical time in the multiport approach was 167 min versus SILS with 129 min. Laparoscopic intestinal resection was performed in 4.4% of patients, through multi-port using intracorporeal anastomosis. Mean hospital stay of 3.2 days for the SILS approach versus multi-port in 2.2 days. Conclusions: Both laparoscopic approaches, in MASBO treatment is feasible in qualified hands. Patient selection and medical judgment seem to be the most essential factors for a positive result.



Keywords: Hand-assisted laparoscopy. Intestinal obstruction. Laparoscopy. Surgery. Tissue adhesions.