Laparoscopic evaluation for chronic post operative abdominal pain

Approximately 20% of patients undergoing laporotomy experience chronic post-prandial abdominal pain for months after operation. Most surgeons are wary of re-operation in this condition, and opt for conservative treatment with analgesics and sedatives. This study was performed to determine the cause of this chronic abdominal pain by means of laparoscopy.

Elective laparoscopic surgery was performed on 76 patients suffering from chronic post-operative abdominal pain. They did not have any signs and/or symptoms of acute intestinal obstruction; the most common complaints were: abdominal pain in 100%, nausea in 30%, vomiting in 10%. Diagnostic laparoscopy was performed and cases with positive findings were treated by laporoscopic surgery.

In 81% of patients the cause of pain was obvious intestinal adhesions, 10% had adhesions without any correlation to patient's symptoms and the remaining 9% did not have any positive finding on diagnostic laparoscopy. Adhesiolysis, (sharp release with scissors) is the treatment of choice. 95% of those patients who underwent Adhesiolysis became pain free for a mean average of 11 months follow up (pre-operative average of pain episode was 4 time per week).

Laparoscopic diagnosis and treatment of chronic post-laparotomy pain is the gold standard method, it is minimally invasive and has good results.