Experience and possibilities of video laparoscopy in emergency abdominal surgery

Abstract

Objective. To evaluate the effectiveness and improve treatment outcomes for patients with acute abdominal pathologies using video laparoscopy. Materials and methods. The paper is based upon a ten-year experience of using video laparoscopy in emergency abdominal surgery. Within a decade (2008 2018), 23127 patients had been admitted to the surgical department of City Emergency Hospital in the city of Rostov-on-Don; among them 19748 patients were operated on. Video laparoscopic surgeries for acute appendicitis, acute cholecystitis, acute intestinal obstruction, perforated gastric and duodenal ulcers, and other acute abdominal surgical pathologies were performed in 15124 patients; the share of these interventions was 76.6 % of all cases.
 Results. Initially, when laparoscopy was introduced in emergency abdominal surgery, diagnostic laparoscopy was used in more than a half of the performed surgeries, mainly for acute appendicitis and abdominal injuries. Today, video endoscopic surgery is widely used for acute cholecystitis, acute pancreatitis, perforated ulcers, strangulated hernias, torsions of epiploic appendages of the colon and of the greater omentum. An effective use of video laparoscopy for therapeutic purposes allows increasing the number of laparoscopic operations performed in patients with emergency surgical pathology of abdominal organs.
 Conclusions. Video laparoscopy in urgent surgery allows establishing a diagnosis in time, performing dynamic video laparoscopy, eliminating concomitant pathology, diagnosing and, in some cases, preventing postoperative complications. Video laparoscopic surgery is easier for patients to tolerate; it reduces the number of complications, the period of staying at the hospital and the rehabilitation period, and opens up new possibilities for helping patients with emergency surgical conditions.