Technical note: Minimally invasive ‘second look’ in the era of laparoscopic surgery

Benefits associated with minimally invasive surgery, in both elective and emergency practice, are well established. In recent years, laparoscopic surgery has been embraced, and has gained increasing popularity. We describe a modification of a previously described technique in the context of the ‘second look’ in the era of laparoscopic surgery.

A seventy year old patient with type one respiratory failure presented with an acute abdomen. Pre-operative imaging suggested mesenteric ischaemia. A decision was made to proceed with laparoscopic surgical intervention. An infarcted small bowel segment was identified and resected. A primary anastomosis was constructed, but in view of the underlying pathological process, it was felt that a ‘second look’ was required. This was facilitated by leaving an 11mm port in left lower quadrant after the primary procedure, so that twenty four hours post-operatively the anastomosis could be inspected.

The concept of the ‘second look’ is well established in the context of mesenteric ischaemia. A laparoscopic ‘second look’ following open surgery has been previously described. We have embraced the ‘second look’ concept and we were able to perform both procedures in a minimally invasive fashion.

Publication History

Received: 05 December 2009

Accepted: 01 March 2010

Article published online:
23 May 2022