Laparoscopy in gastrointestinal emergency

Abstract

BACKGROUND: Laparoscopy is an established component of modern visceral surgery. To one extent or another, it is used for operations on virtually all abdominal organs, depending on the specialization and expertise of the respective department. In spite of its extensive use, there are no clear guidelines for the application of laparoscopy in acute situations. The reports in the literature do not at present suffice for the formulation of such guidelines. METHODS: This survey covers the role of laparoscopy in seven different types of emergency abdominal surgery. We carefully evaluated the relevant literature on the use of laparoscopy in emergency abdominal surgery. RESULTS: Many relevant works are case reports or uncontrolled series that are only concerned with feasibility. Further, comparative studies often have poor selection criteria and so cannot provide a reliable answer to the question as to whether laparoscopic technique should be used in gastrointestinal emergencies. Our experience shows that laparoscopy is also suitable for acute abdominal situations. CONCLUSIONS: Laparoscopy can be successfully applied for all seven indications considered here. Patient safety and efficacy depend on the experience and manual dexterity of the laparoscopic surgeon. It should be borne in mind that in emergency settings, it is important to recognize in time the need to convert to open surgery