Laparoscopic bowel injury.

Laparoscopy is not a new procedure, but instead represents a minimally invasive method of access to the peritoneal cavity, accomplishing the same procedures under laparoscopic guidance as performed through a large abdominal incision. The adoption of any new surgical procedure or technology is associated with new as well as previously recognized complications. Intestinal injuries associated with laparoscopic surgery can occur as a result of insufflation needle or trocar insertion, or they can occur during the operative dissection. Insufflation needle injuries are usually self-limiting and require no specific treatment. Injuries associated with trocar insertion or operative dissection should be identified and managed appropriately. As surgeons increase their experience with laparoscopic surgery, they should be able to manage many such injuries without needing to convert to open laparotomy. Direct suture repair under laparoscopic guidance and the use of innovative endoscopic stapling devices have been successfully used to manage such injuries.