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

Abstract

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.

The Role of Laparoscopy in Penetrating Abdominal Trauma: Our Initial Experience

“…In this study, among 106 patients managed laparoscopically, 63 (58.5%) patients had TL. Despite the fact that laparoscopic repair to virtually every organ has been described, including the diaphragm, stomach, small intestine, colon, bladder, pancreas, and spleen, with impressive results, 10 in most reported series TL is limited to a specific anatomical location, for example, the anterior abdominal area and the lower chest, 4,5,[11][12][13] or to minor injuries. By contrast, Cherkasov et al 14 offered laparoscopic surgery to patients with injuries to the abdominal and lumbar areas and did not limit this surgery only to anterior abdominal injuries.…”

Diagnostic and therapeutic potentials of laparoscopy in abdominal trauma

“…Многие авторы сооб-щают об успешном применении лечебной лапаро-скопии при абдоминальной травме [7,13,16,22,25,[35][36][37][38][39][40][41][42][43][44][45][46][47].…”

“…Большинство хирургов сообщают об отсутствии пропущенных по-вреждений [13, 17, 29-32, 35, 36, 47]. Применение диагностической и лечебной лапароскопии, по мне-нию многих авторов, позволяет избежать напрасной лапаротомии в 30-50% случаев [13,[22][23][24]47].…”

Robotic Transthoracic Repair of a Right-Sided Traumatic Diaphragmatic Rupture

“…1 4 5 6 7 As MIS has been shown to reduce respiratory complications, pain, and faster recovery compared with open surgery, incorporating MIS in selected trauma patients may spare them from the morbidities of open operations. 8 Several centers have published case reports of thoracoscopic or laparoscopic repair of traumatic diaphragm ruptures in delayed settings with either primary repair with nonabsorbable sutures or patch closure of the diaphragm with mesh. 6 Here, we report the first case of a robotic transthoracic repair of a right-sided traumatic diaphragm rupture in an acute setting during the index admission.…”