Manually repositioning the small bowel and omentum reduces early postoperative small bowel obstruction (epsbo) after laparoscopic colorectal surgery.

• epsbo rates fell from 4.5% to 1.4% after adopting the repositioning technique (p=0.003).
• Omission of this technique increased epsbo risk threefold (odds ratio 3.09).

Incorporating this simple maneuver can enhance patient outcomes without extending surgery time or increasing complications.

• Other risk factors included stoma creation (odds ratio 4.79) and intra-abdominal abscess (odds ratio 2.84).