Adhesive intestinal obstruction is one of the common diseases of the abdomen, and there are many factors for the formation of intestinal adhesions, while those caused by abdominal surgery account for about 80%. Although traditional open surgery can eliminate the original adhesions, surgeons and patients are afraid of surgical treatment due to the high incidence of re-adhesions, therefore, adhesional intestinal obstruction has been a difficult problem in clinical treatment. The treatment of intestinal adhesions can be divided into conservative treatment and surgical treatment. Conservative treatment mainly consists of fasting, infusion, oral Chinese medicine, etc. As long as the treatment is proper, it can often be relieved, but it can be recurred with a little inattention. Surgery can remove the adhesions and completely release the intestinal adhesions, but the trauma of open surgery itself has the risk of re-adhesions, so both patients and doctors are more cautious when choosing surgery. Is there a better treatment option? In recent years, laparoscopic intestinal adhesion release has given a positive answer. In recent years, laparoscopic adhesion release has achieved more satisfactory results in the treatment of adhesive intestinal obstruction.
This method is performed by placing a laparoscope into the abdominal cavity, observing it comprehensively, and then placing surgical instruments after finding the adhesions and performing surgery. Generally, only 3~4 small holes of 0.5~1cm are needed to complete the adhesion release surgery, which can achieve the purpose of open surgery to release the adhesions completely, while it reduces the occurrence of re-adhesions and avoids the shortage of open surgery.
I. Timing 1. Those who have no abdominal pain for a long time after abdominal surgery, such as sudden onset of abdominal pain, vomiting and other typical symptoms of intestinal obstruction, should generally undergo laparoscopic surgery as early as possible; 2. If the abdominal pain is recurrent and more frequent, laparoscopic exploration can be performed as early as possible to clarify the location of the lesion.
Advantages 1, can be far from the original surgical site in a comprehensive, systematic exploration of the abdominal cavity, observe the site and scope of adhesions, to avoid open surgery in the original scar into the abdomen easy to damage the adhesions of the intestinal canal, destroy the local lesion structure and relationship shortcomings; 2, small surgical trauma, separation of the trauma is also small, no large surgical scars on the abdominal wall, reducing the probability of re-adhesion; 3, the abdominal wall incision site away from the traumatic intestinal canal and original adhesions 4, the operation is less invasive, recovery is fast, patients can get out of bed early, and gastrointestinal function is also recovered quickly, all of which can effectively prevent re-adhesion.
Therefore, the treatment of adhesive intestinal obstruction by laparoscopic adhesiolysis not only has the advantages of complete surgical release of the original adhesions, but also has the advantages of small trauma, incision away from the original adhesions, early bed activity and fast recovery of gastrointestinal function, etc., and can prevent the occurrence of re-adhesions and improve the treatment effect of adhesive intestinal obstruction.