Abstract
Abstract Background: High-grade intestinal obstruction with massive abdominal distension is considered to be an absolute contraindication to laparoscopy. However, improvements in skill level and operator experience makes therapeutic laparoscopy in the above context possible.1–3 Aim: To present video material demonstrating the diagnostic and therapeutic value of laparoscopy, for nonadhesive, high-grade intestinal obstruction, in children. Methods: Two patients, a 4- and a 15-year-old, with no previous abdominal surgery, present with a 24-hour history of abdominal colic, bile-stained vomiting, and massive distension. Abdominal X-ray confirms high-grade distal small bowel obstruction. Emergency laparoscopy via an umbilical (10 mm) and 2 suprapubic ports (5 mm) established the cause of obstruction to be caused by a vitello-diverticular band and a constrictive Meckel's band with volvulus, respectively. A therapeutic division of the band and unravelling of the Meckel's instantly relieved the obstruction. Both d...
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