Laparoscopy Decreases the Laparotomy Rate in Hemodynamically Stable Patients With Blunt Abdominal Trauma

Lee, Po‐Chu; Lo, Chiao; Wu, Jiann‐Ming; Lin, Keng-Li; Lin, Heng-Fu; Ko, Wen‐Je

doi:10.1177/1553350612474496

Cited by 56 publications

(72 citation statements)

References 33 publications

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“…Comparing two groups with similar ISS after repair for blunt HVI and mesenteric injuries, Lin et al [25] reported a mean hospital stay of 11.0 days after laparoscopy as compared to 17.6 days ( p < 0.001) after open surgery. Similar results have been reported by Lee et al [95] (11 vs. 21 days, p < 0.001) and Lim and colleagues [81] (11.5 vs. 17.6 days, p = 0.004).…”

Section: Why Laparoscopy?supporting

confidence: 91%

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Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

2017

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The management of blunt abdominal trauma has evolved over time. While laparotomy is the standard of care in hemodynamically unstable patients, stable patients are usually treated by non-operative management (NOM), incorporating adjuncts such as interventional radiology. However, although NOM has shown good results in solid organ injuries, other lesions, namely those involving the hollow viscus, diaphragm, and mesentery, do not qualify for this approach and need surgical exploration. Laparoscopy can substantially reduce additional surgical aggression. It has both diagnostic and therapeutic potential and, when negative, may reduce the number of unnecessary laparotomies. Although some studies have shown promising results on the use of laparoscopy in blunt abdominal trauma, randomized controlled studies are lacking. Laparoscopy requires adequate training and experience as well as sufficient staffing and equipment.

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Section: Why Laparoscopy?supporting

confidence: 91%

“…Implementation of minimally invasive surgery in trauma has been reported to avoid trauma laparotomies in 7.7 to 60.7% [82, 94, 95]. Conversion rates in blunt trauma laparoscopy ranged from 8.5 to 23.8% [25, 41, 55, 82] depending on patient selection criteria.…”

Section: Why Laparoscopy?mentioning

confidence: 99%

Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

2017

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“…Contemporary reports paint a very different picture with reported missed injury rates with DL approaching <1% (6)(7)(8)(9)27). The value of a standardized examination for laparoscopy to achieve this result has been demonstrated in both blunt and penetrating trauma (8,31). This highlights that the utility of laparoscopy as a diagnostic tool likely relies most heavily on the skill of the operating surgeon.…”

Section: Screening and DLmentioning

confidence: 99%

Through the 10-mm Looking Glass: Advances in Minimally Invasive Surgery in Trauma

Grushka

Ginzburg

2014

Scand J Surg

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Background: Minimally invasive surgery is increasingly being used in trauma surgery as both a diagnostic and a therapeutic tool. however, significant debate regarding the accuracy, safety, and indications for minimally invasive surgery in trauma continues to impede widespread acceptance of these techniques among trauma surgeons.Method: herein, we report a contemporary review of the current role of both laparoscopy and thoracoscopy in modern trauma surgery. Literature search was performed using PubMed database and the following keywords: "Trauma," "Minimally invasive surgery," "Laparoscopy," and "Thoracoscopy."Results: current recommendations advocate for the use of laparoscopy as a diagnostic tool in penetrating trauma for the diagnosis of diaphragm injuries and peritoneal violation. a significant body of research demonstrates that laparoscopy in select hemodynamically normal patients can significantly decrease nontherapeutic laparotomy rates and hospital costs and is highly sensitive and specific with very low missed injury rates, including small bowel injuries. Laparoscopic repairs to a wide breadth of abdominal and thoracic injuries have been reported with impressive results. adherence to a standardized laparoscopic examination system and routine use of laparoscopy in elective or acute care practice strongly influence positive results with minimally invasive surgery in trauma. video-assisted thoracoscopic surgery is most commonly used for evaluation of diaphragm, evacuation of retained hemothorax, and management of ongoing bleeding post-trauma.Conclusion: Minimally invasive surgery does offer several advantages compared to traditional open surgery and should be considered as an additional tool in the trauma surgeon's armamentarium in the care of select injured patients.

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“…They concluded that when combined with CT scan, DL is a useful tool in the initial evaluation of patients with blunt abdominal trauma. Lee et al 6 had similar findings demonstrating that the use of laparoscopy in patients with abdominal trauma safely decreased the laparotomy rate. Laparoscopy for abdominal trauma is useful in the diagnosis of diaphragmatic rupture, an often missed injury.…”

Section: Resultsmentioning

confidence: 80%

Laparoscopy in Blunt Abdominal Trauma

Nnamonu¹

2017

WJOLS

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Introduction: This review describes the role of laparoscopy in patients with blunt abdominal trauma. Materials and methods:Keywords, such as laparoscopy, blunt, abdominal, trauma were entered into PubMed search engine and filtered for peer-reviewed articles written in the last 5 years. Results and discussion:The findings from these articles are collated and discussed. Conclusion:Laparoscopy is a safe approach both for diagnosis and treatment of patients with blunt abdominal trauma and is associated with the benefits of laparoscopic approach.

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Laparoscopy Decreases the Laparotomy Rate in Hemodynamically Stable Patients With Blunt Abdominal Trauma

Abstract: Laparoscopy is feasible and safe for the diagnosis and treatment of hemodynamically stable patients with blunt abdominal trauma and can reduce the laparotomy rate.

Cited by 56 publications

References 33 publications

Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

Through the 10-mm Looking Glass: Advances in Minimally Invasive Surgery in Trauma

Laparoscopy in Blunt Abdominal Trauma

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