Minimal invasive surgery (MIS) is a safe and feasible approach for acute abdomen with better patient outcomes-3- year NELA data review

Published Date: 01st September 2026

Publication Authors: Blake. D, Kalaiselvan. R

Aim
The role of MIS in elective surgery is fully recognised and established but there is still a general reluctance to incorporate MIS techniques in emergency surgery. The recent NELA data review showed only 14.6% of the cases were approached laparoscopically where half of all cases were converted to open. This study was looking at whether the MIS approach beyond laparoscopic appendectomy and cholecystectomy for NELA eligible cases is safe and feasible.

Methods
From 2022 to 2024, 543 NELA-eligible emergency abdominal surgery cases were identified, with 224 (41%) approached laparoscopically and a 21% conversion rate. Case types included cancer and benign resections, bariatric complications, elective reoperations, and bowel obstruction, with demographics largely similar across groups.

Results
Results indicate MIS is a safe and feasible option for managing acute abdominal emergencies when performed on suitable patients by trained teams with adequate resources. Compared to conventional methods, mortality and morbidity rates were similar, but MIS had shorter hospital stays (12 vs. 15 days) and fewer wound complications (11% vs. 29%). Most MIS surgeries occurred during the day, and nearly 60% involved trainees under supervision. Over half of bowel resections used a laparoscopic approach.

Conclusion
Haemodynamic instability, time of day, patient and surgeon factors played a significant role in choosing one approach to the other.

Despite limitations, the minimal invasive approach is a safe and feasible option to deal with acute abdomen and abdominal catastrophise when there is an eligible patient, skill sets and resources are present.

Blake, D; Majeed, T; Kalaiselvan, R. (2026). P159 Minimal invasive surgery (MIS) is a safe and feasible approach for acute abdomen with better patient outcomes-3- year NELA data review. Colorectal Disease. 28(S1), [Online]. Available at: https://dx.doi.org/10.1111/codi.70578 [Accessed 15 October 2026]