Laparoscopic small bowel resections with intracorporal anastomosis in emergency settings – a retrospective single centre study

Introduction: Minimally invasive surgery (MIS) has advantages over the open approach and has, therefore, become the standard for many abdominal procedures. Evidence on MIS small bowel resections with intracorporal anastomosis in emergency settings is scare.

Methods: All consecutive patients requiring small bowel resection with primary anastomosis during emergency hours treated between 2019 and 2024 were collected from the integrated hospital information system at a tertiary referral centre.

Objective: Outcomes of patients with MIS small bowel resection with intracorporal anastomosis were compared to those with open approach.

Results: A total of 427 patients were identified of whom 6 (1.41%) underwent MIS by an experienced MI surgeon. Of these (4 females, 2 males; mean age 62.2, range 29-77 years), two were diagnosed with haemorrhagic small bowel infarction, one with obstructive adhesion-related ileus and three with intestinal gangrene caused by incarcerated hernias. First flatus (median 2, range 1-3 days), postoperative complication rate measured by CCI (Comprehensive Complication Index; median 15.25, range 0-33.5) and length of stay (median 8, range 4-23 days) were lower after MIS compared to the open approach (each p<0.01). There were no anastomotic leaks nor revisional surgeries after MIS. Notably, two patients (33%) developed a trocar site infection which was successfully treated with antibiotic treatment.

Conclusion: Our data suggest that laparoscopic small bowel resections with intracorporal anastomosis in an emergency setting are feasible and safe in highly selected cases if the necessary expertise is available. Attention needs to be paid to trocar site infections.

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Artikel online veröffentlicht:
04. September 2025