Laparoscopy in the management of acute intestinal obstruction: “the new gold standard or a selective tool?". A retrospective cross-sectional study.

Abstract

Background: Acute intestinal obstruction (AIO) is a common surgical emergency requiring prompt diagnosis and management to prevent complications like gangrenous bowel, perforation, sepsis, and death of the patient. While exploratory laparotomy has been the surgical standard for acute intestinal obstruction (AIO), minimally invasive surgery is now frequently favoured for appropriately selected patients. Objective: The aim of this study is to evaluate the role of laparoscopic approach in the management of acute intestinal obstruction, emphasizing its safety and effectiveness in appropriately selected patients. Methods: A retrospective observational study of all the patients diagnosed with acute intestinal obstruction who underwent a laparoscopic approach in a tertiary care hospital from October 2023 to July 2025. The data was collected from the hospital medical records, parameters like age, sex, etiology, the preoperative diagnosis, the procedure, the intra operative diagnosis, operative time, cause of conversion, and postoperative outcome were analyzed. Results: A total of 40 patients were included in the study. Laparoscopy was successfully completed in 87.5% (35) patients with the rate of conversion 5 (12.5%) patients. The most common causes for conversion were dense adhesions, bowel ischemia, and fragile dilated bowel unable to be handled in laparoscopy. The mean operative time was 171.1 minutes. The patients undergoing laparoscopic management had faster recovery, earlier return of bowel function, and timely return to regular activities. Conclusion: Laparoscopy is a safe and effective modality of management in selected cases of AIO in a tertiary care setting, offering both diagnostic and therapeutic benefits, including faster recovery and less postoperative morbidity. Recommendation: Diagnostic laparoscopy should be considered in hemodynamically stable patients with suspected AIO, provided adequate surgical expertise and appropriate patient selection