The objective of our study was to assess the abilities and limitations of laparoscopy and evaluate its role in examination and treatment of patients with abdominal trauma. A total of 628 patients with blunt and penetrating abdominal trauma were included in this retrospective 12-year survey (2000 to 2011). All patients in the study underwent either laparotomy (280 patients) or urgent laparoscopy (348 patients). There was no difference in the demographic data and trauma severity between the 2 groups. Conversion to open surgery was performed in 130 cases (37.3%). Diagnostic laparoscopy without therapeutic manipulations was used in 160 patients (46%) and therapeutic laparoscopy was carried out in 58 patients (16.7%). Quicker recovery time, less pain, shorter hospital stay, and lower complication rate were observed in patients after laparoscopic surgery compared with patients after open surgery. No missed abdominal organs injuries were revealed after laparoscopic examination of abdominal cavity.

Laparoscopic splenectomy is a safe feasible operation in patients with spleen injury. The operation is indicated in patients with spleen laceration >3 cm of parenchymal depth with moderate continuing bleeding or expanding hematoma and contraindicated in patients with hemodynamic instability and high bleeding rate (>500 mL/h on serial ultrasound examinations).

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