Clinical Science Single-port laparoscopic treatment of small bowel obstruction Byung Jo Choi, M.D. a , Say-June Kim, M.D., Ph.D. a , Sang Chul Lee, M.D., Ph.D. a, *, Jae Im Lee, M.D. b a Department of Surgery, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daeheung- dong 520-2, Joong-gu, Daejeon, Republic of Korea; b Department of Surgery, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea KEYWORDS: Small bowel obstruction; Laparoscopy; Single port Abstract BACKGROUND: The aim of this study was to report our initial experience with single-port laparo- scopic surgery (SPLS) for small bowel obstruction (SBO). METHODS: Between October 2009 and April 2013, 36 patients underwent SPLS for SBO. SPLS was performed transumbilically. Patient demographics and operative and postoperative outcomes were analyzed. RESULTS: SPLS for SBO was successful in 35 patients. In 1 patient, a conversion to laparotomy was required. The median incision length, operative time, and postoperative length of stay were 2.3 cm (range, 1.5 to 5.0 cm), 115 min (range, 30 to 250 min), and 8 days (range, 3 to 26 days), respectively. The median time to resume oral intake was 3 days (range, 1 to 16 days). The intra- and postoperative complication rates were 6% and 11%, respectively. CONCLUSION: SPLS was a safe and feasible therapeutic approach for SBO and may also be an excellent diagnostic tool when performed by an experienced SPLS surgeon in selected patients. Ó 2014 Elsevier Inc. All rights reserved. Small bowel obstruction (SBO) is a common cause of acute hospital admissions. Postoperative adhesion is the most common cause of SBO. Laparotomy has been the long-standing treatment of choice for SBO, but it is also a predisposing factor in the development of postoperative adhesions. Laparoscopic adhesiolysis for SBO was intro- duced in 1991 and multiple studies have reported the safety and efficacy of laparoscopic treatment for SBO. 1–3 Despite this, laparoscopy is not widely practiced for SBO, possibly because there has been no assessment of risk factors to indi- cate whether the surgery is beneficial for all patients. Risk factors affecting the success of laparoscopic surgery may include a limitation of the working space or the risk of bowel injury. Furthermore, it may be difficult to identify the obstruction with complete confidence. In clinical prac- tice, single-port laparoscopic surgery (SPLS) was initially used to treat appendicitis and cholecystitis, but it is now widely used in many other areas of surgery. 4–6 To our knowledge, only a single study has reported the use of SPLS for the treatment of SBO in 10 patients. 7 The aim of this retrospective study was an initial assessment of the safety and efficacy of SPLS for the treatment of patients with SBO. There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs. The authors declare no conflicts of interest. * Corresponding author. Tel.: 18242-220-9520; fax: 18242-220-9565. E-mail address: zambo9@catholic.ac.kr Manuscript received August 28, 2013; revised manuscript January 3, 2014 0002-9610/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.amjsurg.2014.01.013 The American Journal of Surgery (2014) 208, 470-475