Laparoscopic small bowel anastomosis: What you need to know

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Nguyen Thai Binh - Gastroenterologist - Department of General Surgery - Vinmec Ha Long International General Hospital.

“Laparoscopic small bowel resection” refers to the surgical technique of removing an abnormal or diseased portion of the intestine (small intestine) and then restoring the digestive tract by laparoscopic abdominal surgery.

1. Designation


Indications for bilateral intestinal anastomosis in case of small bowel tumor: GIST (gastrointestinal tract stromal tumor), ileal carcinoid tumor Acute disease in small intestine: Intestinal obstruction causing necrosis of the intestine (ligament, food residue tumor) causes intestinal obstruction and necrosis, intestinal strangulation due to hernia...) Special and uncommon diseases: Crohn's disease, diffuse polyps in the small intestine (Peutz - Jegher syndrome), intestinal tuberculosis, intestinal vascular abnormalities ...

2. Contraindications


Patients with weak physical condition, respiratory failure do not allow abdominal inflation Patients with a history of abdominal surgery many times Cancer has spread to the peritoneum and distant metastases

3. Advantages of laparoscopic small bowel anastomosis


Cắt nối ruột non bằng mổ nội soi có những ưu điểm vượt trội
Cắt nối ruột non bằng mổ nội soi có những ưu điểm vượt trội

Laparoscopic small bowel surgery is a difficult technique, requiring experience and coordination of both the team and modern equipment. Compared with traditional surgery, laparoscopic small bowel resection is less invasive because of the small cuts. Other advantages of this surgical approach include:
Smaller internal and external scars. Less pain. Shorter hospital stay. The hospital stay after laparoscopic surgery can take as little as 2 nights while with traditional surgery it can take you a week or even more. A shorter hospital stay will save you a lot of money. Faster recovery time. You can make a full recovery 2 or 3 weeks after laparoscopic surgery while traditional surgery may take 4 to 8 weeks for all activities to return to normal.

3. Monitoring and handling of accidents


Theo dõi và xử trí tai biến sau mổ nội soi
Theo dõi và xử trí tai biến sau mổ nội soi

After the 2 hour small bowel resection surgery, the patient's health is stable and recovers well, he can be discharged in the next few days.
3.1. Follow-up As with all gastrointestinal surgery in general, after a small bowel resection, your doctor will prescribe a combination of 2 antibiotics (Metronidazol and Cephalosporine) injected for 5-7 days.
3.2. Complications, complications and management During surgery
Bleeding due to not tight mesenteric cut sites. Treat with hemostasis or clip. If the bleeding cannot be stopped, it must be switched to open surgery, to avoid causing large hematoma in the mesentery.
Had to switch to open surgery because of complicated lesions, many adhesions
After surgery
Intra-abdominal bleeding: Need to re-operate soon to check and manage bleeding. Anastomosis podium: Need to re-operate soon. Tightening of anastomosis: Re-operate to solve the cause Post-operative intestinal obstruction: pain, vomiting, bowel obstruction, abdominal distension... need to treat bowel obstruction soon, antibiotics to aspirate gastric juices prompt follow-up. Complications of intestinal perforation, peritonitis, intra-abdominal bleeding, incision rupture, anastomosis fistula. Doctors recommend that everyone who has an accident, even if it's small, has abdominal pain, they need to go to the doctor right away. Acute abdominal pain can be caused by broken intestines, broken liver, spleen... Do not drive while drinking to avoid unfortunate accidents.
Master, Doctor Nguyen Thai Binh has more than 20 years of experience working in abdominal surgery. He is a former resident of Sainte Marguerite and Nord Hospitals (Marseille, France).

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