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. 2013 Nov 14;28(2):353–379. doi: 10.1007/s00464-013-3171-5
Grade C Adhesiolysis should be performed close to the abdominal wall and not near the bowel
Sharp dissection techniques should be preferred, and the use of energized dissection near the bowel should be avoided
Conversion to laparotomy is advisable if the surgeon is not proficient with laparoscopic bowel repair techniques
A primary open repair is advisable in the presence of gross spillage. An open prosthetic repair may be undertaken if conditions remain sterile
A small laparotomy away from the hernia defect may be used to repair a bowel injury and may be followed by continuation of LVHR
If a bowel injury is repaired laparoscopically, LVHR may be performed after an observation period of 3–7 days during parenteral antibiotic therapy if no evidence of infection is observed
An LVHR may be performed in the event of bowel injury repaired immediately with minimal spillage, but this option requires experience with laparoscopic repair of bowel injury