Non-traumatic acute abdomen: videolaparoscopic approach

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Emergency Medicine

Background:

• Videolaparoscopy is established for elective procedures, but its utility in acute abdominal conditions requires further assessment.
• Non-traumatic acute abdomen presents a diagnostic and therapeutic challenge in emergency settings.
• Evaluating videolaparoscopy's role is crucial for optimizing patient care in acute abdominal emergencies.

Purpose of the Study:

• To evaluate the diagnostic and therapeutic efficacy of videolaparoscopy in patients presenting with non-traumatic acute abdomen.
• To determine the rate of conversion to conventional laparotomy and identify factors influencing this decision.
• To assess the spectrum of conditions managed and the outcomes associated with videolaparoscopic intervention.

Main Methods:

• Retrospective review of 462 patient charts admitted with non-traumatic acute abdomen between January 1992 and December 1996.
• Standard diagnostic workup followed by videolaparoscopy for all patients.
• Laparoscopic procedures categorized by purpose: diagnosis, diagnosis and treatment, or treatment only; conversion to laparotomy was documented.

Main Results:

• Inflammatory causes predominated (82.03%), followed by hemoperitoneum (11.03%), bowel obstruction (3.25%), and perforation (1.74%).
• Videolaparoscopy achieved a high diagnostic rate (99.35%) and therapeutic success (92.86%).
• Conversion to laparotomy was required in only 7.14% of cases, indicating the broad applicability of the laparoscopic approach.

Conclusions:

• Videolaparoscopy is a highly effective tool for both diagnosing and treating non-traumatic acute abdomen.
• The low conversion rate to laparotomy underscores the safety and feasibility of this minimally invasive technique.
• This approach significantly aids in managing a wide range of acute abdominal pathologies, improving patient outcomes.