Title

1. Introduction

2. Reopening Laparotomy and Initial Takedown of Adhesions

3. Dissection and Excision of Capsule

4. Dissection of Area of Obstruction

5. Appendectomy

6. Final Exploration and Hemostasis

7. Closure

8. Post-op Remarks

Encapsulating peritoneal sclerosis (EPS), also known as encapsulating sclerosing peritonitis is a rare but serious condition that is characterized by the formation of a thick, fibrotic layer encasing the small bowel. The pathophysiology involves an inflammatory process that triggers excessive fibrin deposition and collagen production, resulting in the development of a thick, cocoon-like membrane around the intestines. This video is an in-depth demonstration of a complex surgical case involving a repeat exploratory laparotomy for bowel obstruction, with a focus on careful dissection of adhesions, managing serosal tears, and ensuring hemostasis. It is particularly valuable for surgeons, surgical trainees, and medical professionals specializing in emergency abdominal surgery.

Watch this full-length, narrated surgical video of a repeat exploratory laparotomy for encapsulating peritoneal sclerosis performed by Dr. Joshua Ng-Kamstra at Massachusetts General Hospital.

Massachusetts General Hospital