Abstract
IntroductionLaparoscopic surgery has greatly improved surgical outcome in many areas of abdominal surgery. But many concerns of safety have limited its application in abdominal trauma. We hypothesized that laparoscopy could be safe and efficacious in treatment of patients with abdominal trauma, and reduce the laparotomy related complications (i.e. wound infection, pain, or long hospital stay) as avoiding unnecessary laparotomy.MethodsFrom January 2006 to August 2012, a total of 111 patients underwent emergent surgical exploration (laparoscopic, 41; open laparotomy, 70) in Andong General Hospital. Of the 41 patients subjected to laparoscopy, 30 patients had suffered blunt trauma, the remaining 11 patients had sustained penetrating trauma. 31 patients were treated exclusively by laparoscopy and 10 patients underwent laparoscopy-assisted surgery.ResultsThe conversion rate was 18%. Major complication was none without postoperative mortality. Comparing laparoscopic surgery with open laparotomy, lesser wound infection, early gas passage, and shorter hospital stay. Otherwise operative times were similar, and neither approach was complicated by missed injury or postoperative intra-abdominal abscess.ConclusionsLaparoscopic surgery can be performed safely whether injuries are blunt or penetrating, given hemodynamic stability and proper technique. Patients may thus benefit from the shorter hospital stays, greater postoperative comfort (less pain), quicker recoveries, and low morbidity/mortality rates that laparoscopy affords.
Highlights
Laparoscopic surgery has greatly improved surgical outcome in many areas of abdominal surgery
41 patients (36.9%) retained the hemodynamic stability required for a laparoscopic procedure and subsequent analysis
If segmental resection was needed for multiple perforations or transection of bowel or for intestinal ischemic changes due to mesenteric tearing, a laparoscopy-assisted minilaparotomy was performed (Table 3)
Summary
Laparoscopic surgery has greatly improved surgical outcome in many areas of abdominal surgery. Many concerns of safety have limited its application in abdominal trauma. Laparoscopy has greatly improved surgical outcomes in many areas of elective abdominal surgery. Laparoscopy is becoming widely accepted and used with significant advantages in the majority of ACS patients in certain centers with specific experience and laparoscopic skills [1]. A number of safety issues have limited its application in abdominal trauma [2]. Due to a high rate of missed injuries, laparoscopy was not well-received for diagnostic evaluation of trauma to the abdomen. Equipment improvements over time and growing experience on the part of surgeons have overcome former misgivings with respect to penetrating abdominal injuries. Laparoscopy has being slowly attempted as a diagnostic tool for such patients, provided
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