To assess the value of ultrasonically activated scalpel and high frequency electrotome under laparoscopy and laparotomy in treatment of adhesive intestinal obstruction.

Clinical data of twenty-seven adhesive intestinal obstruction patients operated by ultrasonically activated scalpel under laparoscopy in our hospital from Jun. 1999 to Jun. 2010 were retrospectively analyzed and they were compared with 23 patients who underwent electroscalpel enterolysis and 30 cases who underwent laparotomy at the same period.

The operative duration were (62.1 ± 17.7) min in the group of ultrasonically activated scalpel, (98.0±37.0) min in the group of electroscalpel enterolysis, and (115.0 ± 20.2) min in the group of laparotomy. The volume and time were remarkably descendent in the group of ultrasonically activated scalpel comparing to the group of electroscalpel enterolysis. So it was in the group of electroscalpel enterolysis, comparing to the group of laparotomy (P < 0.01) . Mean bleeding were (13.9 ± 4.4) ml, (35.0 ± 6.4) ml and (150.0 ± 35.0) ml, respectively. And the mean length of stay were (3.2 ± 0.5) d, (6.1 ± 1.0) d and (11.8 ± 4.0) d, which was remarkably descendent in the group of ultrasonically activated scalpel or electroscalpel enterolysis comparing to the group of laparotomy (P < 0.01) . There was no complication in the group of ultrasonically activated scalpel, 2 cases happened in the group of electroscalpel enterolysis and 7 cases in the group of laparotomy. They were remarkably differential in groups (P < 0.05) .

Enterolysis using laparoscope and ultrasonically activated scalpel to treat adhesive intestinal obstruction is safe and feasible. It has the advantages of short operative time and hospital stay, less invasion and complications, and lower recurrence rate.