Main Article Content
Trauma surgery is traditionally carried out through open procedures; however, the use of laparoscopy in stable patients has been gaining room due to favorable outcomes reported in different studies available in the literature. Nowadays, laparoscopy applied to trauma cases can be divided into screening, diagnosis, and therapeutic applications. Laparoscopic surgery application was initially limited to screening procedure focused on finding peritoneal violations; such a procedure would be followed by exploratory laparotomy. The benefits of using laparoscopy in trauma cases as diagnostic tool to rule out intra-abdominal injuries that may have gone unnoticed in computed tomography, such as diaphragmatic injuries can be easily seen. It can be used to prevent unnecessary laparotomies in patients with penetrating injuries, whose fascial breach cannot be clinically or radiologically ruled out. This paper describes the current indications for the use of laparoscopy in trauma, its potential benefits as well as complications related to the technique. We highlight and describe the importance of systematization for investigation of the peritoneal cavity as well as the expansion of indications for treatment of certain lesions by exclusive laparoscopic approach. This is due to the development of equipment as well as a greater number of surgeons trained in advanced laparoscopic surgery. We also present the main potential complications related to the method as well as the limitations still encountered today.
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
2. Birindelli A, Podda M, Segalini E, et al. Is the minimally invasive trauma surgeon the next (r)evolution of trauma surgery? Indications and outcomes of diagnostic and therapeutic trauma laparoscopy in a level 1 trauma centre. Updates Surg. 2020; Jun;72(2):503-512. doi: 10.1007/s13304-020-00739-0. Epub 2020 Mar 26. PMID: 32219731.
3. Renz BM, Feliciano DV. Unnecessary laparotomies for trauma: a prospective study of morbidity. J Trauma. 1995;38(3):350–356.
4. Uranues S, Popa DE, Diaconescu B, Schrittwieser R. Laparoscopy in penetrating abdominal trauma. World J Surg. 2015; Jun;39(6):1381-8. doi: 10.1007/s00268-014-2904-5. PMID: 25446491.
5. Di Saverio S, Birindelli A, Podda M et al. Trauma laparoscopy and the six w's: Why, where, who, when, what, and how? J Trauma Acute Care Surg. 2019; Feb;86(2):344-367. doi: 10.1097/TA.0000000000002130. PMID: 30489508.
6. Koto MZ, Matsevych OY, Mosai F, Patel S, Aldous C, Balabyeki M. Laparoscopy for blunt abdominal trauma: a challenging endeavor. Scand J Surg. 2019; Dec;108(4):273-279. doi: 10.1177/1457496918816927. Epub 2018 Dec 6. PMID: 30522416.
7. Loffer FD, Pent D. Indications, contraindications and complications of laparoscopy. Obstet Gynecol Surv. 1975; Jul;30(7):407-27. doi: 10.1097/00006254-197507000-00001. PMID: 124409.
8. Kindel T, Latchana N, Swaroop M, et al. Laparoscopy in trauma: an overview of complications and related topics. Int J Crit Illn Inj Sci. 2015; 5:196–205. doi:10.4103/2229- 5151.165004.
9. Menegozzo CAM, Damous SHB, Alves PHF, Rocha MC, Collet e Silva FS, Baraviera T et al. “Pop in a scope”: attempt to decrease the rate of unnecessary nontherapeutic laparotomies in hemodynamically stable patients with thoracoabdominal penetrating injuries. Surg Endosc. 2020; 34:261-267. https:// doi.org/ 10. 1007/ s00464- 019- 06761-7
10. Hajibandeh S, Hajibandeh S, Gumber AO, Wong CS. Laparoscopy versus laparotomy for the management of penetrating abdominal trauma: A systematic review and meta-analysis. Int J Surg. 2016; Oct;34:127-136. doi: 10.1016/j.ijsu.2016.08.524. Epub 2016 Aug 26. PMID: 27575832.
11. Cabrera Vargas LF, Pedraza M, Rincon FA, et al. Fully therapeutic laparoscopy for penetrating abdominal trauma in stable patients. Am J Surg. 2022; Jan;223(1):206-207. doi: 10.1016/j.amjsurg.2021.07.008. Epub 2021 Jul 17. PMID: 34294385.
12. Clarke DL, Brysiewicz P, Sartorius B, Bruce JL, Laing GL. Hypotension of B110 mmHg is associated with increased mortality in South African patients after trauma. Scand J Surg. 2017; 106(3):261-268. doi:10.1177/1457496916680129.
13. Matsevych O, Koto M, Balabyeki M, Aldous C. Trauma laparoscopy: when to start and when to convert? Surg Endosc. 2018; Mar;32(3):1344-1352. doi: 10.1007/s00464-017-5812-6. Epub 2017 Aug 10. PMID: 28799045.
14. Matsevych OY, Koto MZ, Motilall SR, Kumar N. The role of laparoscopy in management of stable patients with penetrating abdominal trauma and organ evisceration. J Trauma Acute Care Surg. 2016; Aug;81(2):307-11. doi: 10.1097/TA.0000000000001064. PMID: 27032004.
15. Li Y, Xiang Y, Wu N, et al. A comparison of laparoscopy and laparotomy for the management of abdominal trauma: a systematic review and metaanalysis. World J Surg 2016; 39:2862–2871. doi:10.1007/s00268-015- 3212-4.
16. Koganti D, Hazen BJ, Dente CJ, Nguyen J, Gelbard RB. The role of diagnostic laparoscopy for trauma at a high-volume level one center. Surg Endosc. 2021; Jun;35(6):2667-2670. doi: 10.1007/s00464-020-07687-1.
17. Menegozzo CAM, Damous SHB, Sabioni GR, et al. Could trauma laparoscopy be the standard of care for hemodynamically stable patients? A retrospective analysis of 165 cases. Surg Endosc. 2023; May 22. doi: 10.1007/s00464-023-10121-x. Epub ahead of print. PMID: 37217684.
18. Nicolau AE, Craciun M, Vasile R, Kitkani A, Beuran M. The Role of Laparoscopy in Abdominal Trauma: A 10-Year Review. Chirurgia (Bucur). 2019; May-Jun;114(3):359-368. doi: 10.21614/chirurgia.114.3.359. PMID: 31264574.