Intra-abdominal adhesions after surgery may occur as normal recovery or can lead to complications as obstruction, pain, emergency, or anatomical limits for nor­mal life [6]. Although the exact pathological mechanisms have not been fully eluci­dated, surgical trauma, infection, tissue ischemia, and foreign bodies are some of the reasons to induce brin deposition. Some experimental laboratory models sug­gested acute peritoneal inammation after CO2 pneumoperitoneum depending on the insufation pressure and surgery duration [7, 8]. The peritoneum suffers an imbalance between brin forming and brin dissolving, which results in the post­surgical adhesions [9]. To avoid this formation as much as possible surgical preven­tion is an important rule [10, 11]. Adhesions were found in 28% of cadavers with no preceding abdominal surgery, and in those that had had abdominal surgery 67% had adhesions. Laparotomy is the standard access for obstructive acute abdomen with suspicious small bowel adhesion [12]. Adhesional small bowel obstruction is an emergency condition that has high-risk distention to get into during a laparoscopy and/or robot-assisted procedures [13–15]. Adhesions related to prior hernia surgery account for 10% of small bowel obstruction and are often associated with strangula­tion. Despite laparoscopic adhesiolysis not being recommended (evidence level 4) as an alternative to the laparotomic approach for small bowel obstruction (recom­mendation C grade), several studies have demonstrated laparoscopic surgery is a safe and acceptable alternative even for more complex small bowel obstruction [16].