Laparoscopy for stable penetrating abdominal trauma

Area of Science:

• Trauma Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Trauma laparotomy is standard for penetrating abdominal trauma but has risks.
• Laparoscopy is explored as a potentially less invasive alternative.
• This study assesses laparoscopy's applicability and potential to reduce non-therapeutic laparotomies.

Purpose of the Study:

• To evaluate the feasibility of laparoscopy in managing hemodynamically stable patients with penetrating abdominal trauma.
• To determine if laparoscopy can decrease the rate of non-therapeutic laparotomies compared to traditional laparotomy.

Main Methods:

• Retrospective analysis of 127 hemodynamically stable patients with penetrating abdominal trauma (Jan 2018-Dec 2022).
• Data included demographics, imaging, surgical findings, interventions, and outcomes (mortality, complications, length of stay).
• Patients were grouped into laparoscopy, laparoscopy converted to laparotomy, and laparotomy.

Main Results:

• A high rate of non-therapeutic laparotomies (28%) was observed.
• Diagnostic imaging (E-FAST, CT) was more frequently positive in the laparotomy group.
• Common injuries involved the liver, diaphragm, and abdominal organs; common interventions included liver hemostasis and diaphragm repair.

Conclusions:

• Laparoscopy is feasible for penetrating abdominal trauma in experienced surgeons.
• A significant proportion of laparotomies were non-therapeutic.
• Prospective studies are essential to confirm laparoscopy's safety and efficacy in trauma care.