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Laparoscopic-assisted Small Bowel Resection for Retained Endoscopic Capsule

Contributors: Anna Sabih and Edward Auyang

This video depicts a laparoscopic-assisted approach for the retrieval of an endoscopic capsule retained within the small bowel.

DOI: http://dx.doi.org/10.17797/prub9rczs1

Editor Recruited By: Jeffrey B. Matthews, MD

An exploratory laparoscopy was performed in order to locate the retained endoscopic capsule. When this was achieved, an open small bowel resection through a limited midline abdominal incision was performed.
The patient was a 51 year-old woman who had a history of NSAID-related small bowel stricture and a prior open small bowel resection. Four years after her surgery, the patient developed abdominal pain and underwent a capsule endoscopy procedure, however the capsule was unable to successfully traverse the GI tract, and instead became stuck at the site of her prior small bowel anastomosis.
None present.
Supine position.
1. H&P 2. Labwork 3. Fluoroscopy with small bowel follow through
Laparoscopic port placement consisted of three 5mm ports: a camera port in the left middle quadrant, and working ports in the left upper and lower quadrants.
The advantage of a laparoscopic-assisted approach is that it allowed for smaller midline incision to be made for the small bowel resection. The benefit of a smaller incision includes decreased postoperative pain, as well as decreased chance of future incisional hernia. The disadvantage of a minimally invasive approach is that locating the retained capsule can be slightly more challenging, due to the limited tactile sensation afforded by the laparoscopic instruments when compared with an open approach.
No postoperative complications occurred.
No postoperative complications occurred.
N/A
NSAIDs: Adverse effects on the distal small bowel and colon. www.uptodate.com

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