Acute paralytic intestinal obstruction complicated by peritonitis is common and serious condition that necessitates urgent surgery. Mortality amounts to 8.9-69.9%. According to the data the objective of the study is to reduce risk of recurrence of the disease, raise efficacy of prevention by means of current treatment options. Clinical evaluation of 89 patients with acute paralytic ileus with peritonitis has been carried out for 7 years. On the basis of large clinical material corresponding conclusions are made indicating that videolaparoscopic management allows not only eliminating the cause of the disease but also being effective preventive measure after surgical procedure. Besides the technique complies with the requirements of cosmetic surgery. The most important thing is that the given method prevents recurrence of adhesions that is crucial in patients who are prone to formation of adhesions.