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Utilizing Video-Assisted Retroperitoneal Debridement for Retroperitoneal Abscess Following Penetrating Trauma.

Brian B McCluskey1, Cory J Nonnemacher1, Dennis W Ashley1

  • 1Department of Surgery, Mercer University School of Medicine, Macon, GA, USA.

The American Surgeon
|March 29, 2024
PubMed
Summary

Video-assisted retroperitoneal debridement (VARD) offers a minimally invasive solution for complex post-trauma retroperitoneal abscesses. This approach provides rapid improvement for patients who have not responded to conservative treatments like antibiotics and drainage.

Keywords:
retroperitoneoscopytraumavideo-assisted retroperitoneal debridement

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Area of Science:

  • Surgical Innovation
  • Trauma Surgery
  • Minimally Invasive Procedures

Background:

  • Retroperitoneal abscesses following penetrating trauma present complex surgical challenges.
  • Limited literature exists to guide management decisions for these specific cases.
  • A step-up approach, similar to other infected fluid collections, is logical.

Purpose of the Study:

  • To describe the experience of using Video-assisted retroperitoneal debridement (VARD) for post-trauma retroperitoneal abscesses.
  • To evaluate the efficacy of VARD in patients who failed conservative management.
  • To establish VARD as a viable surgical option for specific trauma-related retroperitoneal abscesses.

Main Methods:

  • Case series describing two patients with retroperitoneal abscesses post-gunshot injury.
  • Patients initially managed with antibiotics and percutaneous drains without success.
  • Subsequent treatment involved Video-assisted retroperitoneal debridement (VARD).

Main Results:

  • Both patients experienced rapid clinical improvement following VARD.
  • Patients were discharged within days of the VARD procedure.
  • VARD was effective in managing complex retroperitoneal abscesses post-trauma.

Conclusions:

  • Video-assisted retroperitoneal debridement (VARD) is a feasible and effective treatment for post-trauma retroperitoneal abscesses.
  • VARD should be considered when surgical intervention is indicated and patient anatomy is suitable.
  • This minimally invasive approach offers rapid recovery for selected patients.