Laparoscopic approach to abdominal trauma. Experience in a trauma hospital

Abstract

Background: Background: Historically, midline laparotomy has been the approach used for patients with abdominal trauma with high morbidity and mortality rates. Therefore, laparoscopy is an accepted approach for hemodynamically stable patients (systolic blood pressure > 90 mm Hg) requiring abdominal exploration.
Objectives: The aim of this study was to describe the practice of laparoscopy in abdominal traumas in a trauma hospital for four years.
Material and methods: We conducted a retrospective review of the medical records and operative protocols of patients with open abdominal trauma undergoing laparoscopic surgery. The following variables were analyzed: type of open trauma (gunshot and stab wounds); examination of the wound and request for preoperative computed tomography (CT) scan; type of procedure (diagnostic or therapeutic); intraoperative findings; conversion rate; size of laparotomy; operative time; postoperative complications; and length of hospital stay.
Results: Considering patients with negative laparoscopies (those with injuries that did not require treatment) and those with therapeutic laparoscopies, 68% (19) were completely approached through laparoscopy and avoided the traditional xyphopubic laparotomy used in trauma cases. In addition, in those patients who required a laparotomy to repair their injuries, a shorter laparotomy incision was performed depending on the lesions found. The morbidity and mortality rate were low and length of hospital stay was short.
Conclusion: Laparoscopy is a useful alternative for hemodynamically stable patients requiring abdominal exploration.