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A hole in the bowel treated by a hole– Minimally invasive approach to small bowel perforation

Author: 
Dr. Balaji, P., Dr. Rajkumar Rathinasamy and Dr. Rangarajan
Subject Area: 
Health Sciences
Abstract: 

Background: Small bowel perforation is still a major health problem in the developing world with its attendant high morbidity and mortality. Till date Small bowel perforation has been treated by conventional laparotomy. Early surgery has become the accepted mode of treatment and this has improved survival in the patients. Reports are now available for the feasibility of laparoscopic repair of Small bowel perforation. Laparoscopy provides diagnostic as well as therapeutic capabilities with diagnostic accuracy reaching 100%. The objective of the study was to study the benefit of laparoscopic approach for small bowel perforation. Methods: 5 patients who presented with the small bowel perforation from January 2017 to December 2017 were involved in the study. All patients were haemodynamically stable and were diagnosed within 48 hours of presentation and treated by Laparoscopic approach. Results were analyzed in terms of wound infection, hospital stay, return to work, and mortality. Results: There was no conversion. 3 patients had Duodenal perforation and 2 had Illeal perforation. Perforations treated with intracorporeal suturing in all 5 patients. Laparoscopy reduces postoperative pain, wound infections, hospitalization, and early recovery. There was no chest infection, post-operative intra-abdominal collection and mortality. Conclusions: Laparoscopy is an effective tool in avoiding negative and non-therapeutic laparotomy and offered profound therapeutic potential laparoscopic approach is safe, reliable and feasible, required shorter operative time, lesser analgesia, fewer complications, shorter hospital stay and early recovery.

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