Operative Management of Enteroatmospheric Fistula in Björck 4 Open Abdomen Patients by the Help of Laparoscopic Lateral Approach

Abstract

As the open abdomen (OA) management increases, the number of fistula formation has also been increasing during the last two decades. These fistulas in OA have been defined as enteroatmospheric fistula (EAF). EAF occurring in a frozen OA is classified as Björck 4 OA. Management of Björck 4 OA patient is not easy and mortality of these patients is very high in spite of the presence of modern treatment modalities. There are a few surgical approaches for treatment of Björck 4 OA patients. One of them is excising the hostile segment by lateral abdominal approach from the healthy side or entering from lateral border of OA wound after enough time intervals for subsiding of the edematous intestine in acute inflammatory reaction in the hostile environment. In this case, we present a newly developed surgical technique, called laparoscopic lateral approach which was applied to Björck 4 OA patient for excising hostile intestinal segment and management of the abdominal wall defect.