Role and Limitations of Laparoscopy in Abdominal Trauma

Abstract

Trauma surgery is traditionally carried out through open procedures; however, the use of laparoscopy in stable patients has been gaining room due to favorable outcomes reported in different studies available in the literature. Nowadays, laparoscopy applied to trauma cases can be divided into screening, diagnosis, and therapeutic applications. Laparoscopic surgery application was initially limited to screening procedure focused on finding peritoneal violations; such a procedure would be followed by exploratory laparotomy. The benefits of using laparoscopy in trauma cases as diagnostic tool to rule out intra-abdominal injuries that may have gone unnoticed in computed tomography, such as diaphragmatic injuries can be easily seen. It can be used to prevent unnecessary laparotomies in patients with penetrating injuries, whose fascial breach cannot be clinically or radiologically ruled out. This paper describes the current indications for the use of laparoscopy in trauma, its potential benefits as well as complications related to the technique. We highlight and describe the importance of systematization for investigation of the peritoneal cavity as well as the expansion of indications for treatment of certain lesions by exclusive laparoscopic approach. This is due to the development of equipment as well as a greater number of surgeons trained in advanced laparoscopic surgery. We also present the main potential complications related to the method as well as the limitations still encountered today.