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Diagnostic and therapeutic laparoscopy for penetrating abdominal trauma: a multicenter experience
L F Zantut1, R R Ivatury, R S Smith
1Department of Surgery, University of Sao Paulo, Brazil.
The Journal of Trauma
|May 1, 1997
Summary
Diagnostic laparoscopy is valuable for stable penetrating abdominal trauma patients. Therapeutic laparoscopy is also feasible, offering minimally invasive benefits in select cases.
Area of Science:
- Minimally Invasive Surgery
- Trauma Surgery
- Surgical Diagnostics
Background:
- Skepticism surrounds diagnostic laparoscopy for penetrating abdominal trauma.
- Limited data exists on therapeutic laparoscopy in trauma.
Purpose of the Study:
- To evaluate the role of diagnostic laparoscopy in hemodynamically stable patients with penetrating abdominal trauma.
- To assess the feasibility and outcomes of therapeutic laparoscopy in this patient group.
Main Methods:
- Retrospective analysis of 510 hemodynamically stable patients from three urban trauma centers.
- Inclusion criteria: penetrating abdominal trauma with no urgent celiotomy indications.
- Data collected on laparoscopy outcomes, therapeutic interventions, and subsequent laparotomy rates.
Main Results:
- Laparoscopy avoided laparotomy in 54.3% of patients (277/510).
- Therapeutic laparoscopy was successful in 26 patients (diaphragmatic repair, cholecystectomy, hepatic repair, gastrotomy closure).
- Overall nontherapeutic laparotomy rate was 10.2%; laparoscopy complications were minor (1.96%).
Conclusions:
- Laparoscopy plays a significant diagnostic role in stable penetrating abdominal trauma.
- Therapeutic laparoscopy is practical and feasible for carefully selected patients, providing minimally invasive advantages.