What is the role of laparoscopic surgery in the treatment of intestinal perforation?

Updated: Jul 24, 2020
  • Author: Samy A Azer, MD, PhD, MPH; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

Laparoscopic or laparoscopic-assisted (minilaparotomy) surgery is also being increasingly performed, with outcomes comparable to those of conventional laparotomy. [21] Experience and advances in accessories have enabled endoscopic repair of a significant number of intestinal perforations, such as iatrogenic perforation. Management of such cases must be individualized to the patient.

In a study involving 934 patients with sigmoid diverticulitis, Ritz et al found that the risk of free perforation in acute sigmoid diverticulitis decreases with the increases in the number of previous episodes of sigmoid diverticulitis. They concluded that the first episode has the highest risk for a free perforation. Therefore, the indication for colectomy should not be made on the basis of the potential risk of free perforation. [22]


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