Postoperative intestinal motility following conventional and laparoscopic intestinal surgery.

Overview

OBJECTIVES: To evaluate the influence of conventional vs laparoscopic right-sided colectomy on postoperative motility of the stomach, small bowel, and large bowel, and to study the effects on postoperative intestinal motility of anesthesia only and of laparotomy vs laparoscopy only. DESIGN: Prospective randomized study in a canine model. SETTING: Animal research laboratory. ANIMALS: Twelve mongrel dogs weighting 23.4 to 29.6 kg. INTERVENTIONS: (1) Laparotomy or laparoscopy and (2) 1 week after complete recovery from the first procedure, right-sided colectomy with ileocolic anastomosis using conventional or laparoscopic techniques. End points of the study were (1) the postoperative time until the electrical response activity of the stomach, small intestine, and large intestine returned to a normal interdigestive pattern and (2) the time until first postoperative bowel movement occurred. RESULTS: Median time until return to normal interdigestive pattern of myoelectrical activity after laparoscopic colectomy was about 40% less than after conventional colectomy (P < .05). Time until first bowel movement was 27% reduced (P < .05). CONCLUSIONS: Recovery from postoperative ileus following laparoscopic surgery is more rapid than after conventional surgery in the canine model. Confirmatory human studies should be performed.