Laparoscopy in Diagnosis and Treatment of Small Bowel Diseases

Laparoscopy is defined as the technique of examining the abdominal cavity and its contents by creating a pneumoperitoneum.The first description of a laparoscopic approach goes back to 1901, by Kelling, who showed on a dog model that it was possible to look inside the abdomen by introducing a cystoscope after high-pressure insufflation (Kelling, 1901).The development of the technique over the next 50 years, passed through the creation of specific instruments that made easier accurate and complete examination of the peritoneal cavity, such as the Verres needle, first described to create pneumothorax for treating tuberculosis but successfully used in 1937 for the induction of the pneumoperitoneum (Veress, 1938) and the Hasson trocar (Hasson, 1974).In September 1985 Erich Muhe performed the first laparoscopic cholecystectomy in humans (Litynski, 1998).Muhe used a Veress needle to create a pneumoperitoneum, introduced a laparoscope through the umbilicus, and completed laparoscopic cholecystectomy in 2 hours.The technique was presented at the Annual Congress of the German Surgical Society held in Munich on April 1986, and rapidly became the gold standard in the treatment of symptomatic gallstones.Fast and worldwide success of laparoscopic cholecistectomy was based on the analysis of results in terms of hospitalization, bowel function resumption, wound-related complications and return to daily activities, which were much more satisfying as compared to those obtained with the open technique, thus causing rapid acceptance by surgeons and increasing demand by patients.The laparoscopic approach was widely applied in abdominal surgery, for the treatment of a great number of benign disea s e , f r o m M R G E t o h e r n i a , a n d e v e n t o procedures in which dissection and extraction of solid organs was contemplated, as safe and easy techniques rapidly developed.This affected transplantation surgery in the way that people who accept to donate the kidney rapidly increased after the diffusion of the laparoscopic approach, because of the decreased morbidity of the operation.Although first met with skepticism, laparoscopy have been applied to malignancies, especially to colon cancer.Many multicenter prospective randomized trials comparing laparoscopic and open technique in colon cancer surgery, unequivocally demonstrated the same favorable short term results of laparoscopic colectomy shown when this approach was adopted for other benign diseases (less intra-operative bleeding, less post-operative pain, morbidity and www.intechopen.com