Role of laparoscopy in patients with abdominal trauma: Rashid Hospital Trauma Center experience

Abstract

Background: Exploratory laparotomy has been the standard intervention for surgical evaluation or treatment of abdominal trauma. Laparoscopic surgery with its proposed favorable surgical outcome may provide a reliable and accurate diagnosis of the injury. In this study, we aim to define the diagnostic role of laparoscopy in abdominal trauma and define the proposed advantages of reducing nontherapeutic laparotomies. Methodology: The study is a cohort retrospective study conducted at a level I trauma center – Rashid Hospital, United Arab Emirates. All patients from January 2016 to May 2019 with a history of abdominal trauma requiring surgical intervention fulfilling the inclusion criteria were included. The outcome of this study was to look at the rate of reduction of nontherapeutic laparotomies and the rate of missed injury. Results: The rate of reduction of nontherapeutic laparotomy in patients with abdominal trauma using diagnostic laparoscopy was 19.4%. Post-operative complications were higher in the open exploration group (p-value = 0.04). No missed injury was reported among the laparoscopy group. The mean hospital stay was higher in the laparotomy group compared to the laparoscopy group (13.6 vs 17.1). Laparoscopy was successful in 68.4% of the patients and the conversion rate was 31.6%. Conclusions: Laparoscopy has a role in the diagnosis of intra-abdominal injuries of hemodynamically stable patients with suspected abdominal injury to reduce unnecessary laparotomies, thereby decreasing postoperative complications.