[Indications for laparoscopy in the diagnosis and treatment of abdominal trauma]

The use of laparoscopy as a diagnostic method dates back to the first decades of this century. Laparoscopic surgical techniques were first used by gynecologists and later, in 1989, Dubois performed the first cholecystectomy using a laparoscopic approach. Since then, in the space of a few years, there has been an overwhelming spread of videolaparoscopic operating methods, extending the therapeutic possibilities to gastroenterological surgery, as well as to thoracic, oncological, urological, and of course, gynecological surgery. The use of the laparoscope as a diagnostic method in abdominal trauma was proposed in the 70s by a number of authors, but only now, due to technological progress and the constant use of elective laparoscopic surgery, have surgeons been able to use this method for the diagnosis and treatment of patients with blunt or penetrating abdominal trauma. The experience accumulated to date includes a restricted number of cases, but preliminary results are encouraging and it is expected that this method will also be extended to emergency traumatology. The authors' preliminary experience consists of 7 laparoscopic examinations in subjects with abdominal trauma and hemoperitoneum. In 6 patients the examination confirmed hemoperitoneum caused by splenic lesion in 5 cases and hepatic lesion in 1 case. A hematoma of the left mesocolon was observed in one patient and the authors refrained from other treatment. In one subject with a splenic rupture at the ileum it was necessary to convert the operation into splenectomy. In a further 5 cases repeated washing and aspiration were used, using biological necks when necessary, until bleeding had completely ceased.(ABSTRACT TRUNCATED AT 250 WORDS)