Laparoscopic surgery in abdominal trauma: a single center review of a 7-year experience

INTRODUCTION: Laparoscopic surgery has greatly improved surgical outcome in many areas of abdominal surgery. But many concerns of safety have limited its application in abdominal trauma. We hypothesized that laparoscopy could be safe and efficacious in treatment of patients with abdominal trauma, and reduce the laparotomy related complications (i.e. wound infection, pain, or long hospital stay) as avoiding unnecessary laparotomy. METHODS: From January 2006 to August 2012, a total of 111 patients underwent emergent surgical exploration (laparoscopic, 41; open laparotomy, 70) in Andong General Hospital. Of the 41 patients subjected to laparoscopy, 30 patients had suffered blunt trauma, the remaining 11 patients had sustained penetrating trauma. 31 patients were treated exclusively by laparoscopy and 10 patients underwent laparoscopy-assisted surgery. RESULTS: The conversion rate was 18%. Major complication was none without postoperative mortality. Comparing laparoscopic surgery with open laparotomy, lesser wound infection, early gas passage, and shorter hospital stay. Otherwise operative times were similar, and neither approach was complicated by missed injury or postoperative intra-abdominal abscess. CONCLUSIONS: Laparoscopic surgery can be performed safely whether injuries are blunt or penetrating, given hemodynamic stability and proper technique. Patients may thus benefit from the shorter hospital stays, greater postoperative comfort (less pain), quicker recoveries, and low morbidity/mortality rates that laparoscopy affords.