Laparoscopy for blunt abdominal trauma: a challenging endeavor

M. Z. Koto, O. Y. Matsevych*, F. Mosai, S. Patel, C. Aldous, M. Balabyeki

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background and Aims: Laparoscopy in blunt abdominal trauma is challenging because of multiple associated injuries, higher trauma score values and higher morbidity and mortality, as compared with patients with penetrating abdominal trauma. The aim of this study was to investigate the role of laparoscopy in the management of blunt abdominal trauma patients and to highlight related challenges. Material and Methods: Over a 4-year period, patients managed laparoscopically for blunt abdominal trauma were retrospectively analyzed. Perioperative details, indications for laparoscopy and conversion, complications, and length of hospital stay were discussed. Results: A total of 35 stable patients underwent laparoscopy. The mean Injury Severity Score was 12 (4–38). Therapeutic laparoscopy was performed in 15 (56%) and diagnostic in 12 (44%) patients. Eight (23%) patients were converted to therapeutic laparotomy. Intraoperative bleeding, complex injuries, visualization problem, and equipment failure necessitated conversion. Three (30%) patients with negative computed tomography scan had therapeutic laparoscopy for mesenteric injuries. There were no missed injuries. The mean length of hospital stay was 11 days in both groups. Conclusion: Laparoscopy for stable patients is feasible and safe. Multiple injuries make laparoscopy more difficult, and advanced laparoscopic skills are required. The conversion rate is high; however, the non-therapeutic laparotomies were completely eliminated in this study.

Original languageEnglish
Pages (from-to)273-279
Number of pages7
JournalScandinavian Journal of Surgery
Volume108
Issue number4
DOIs
Publication statusPublished - 1 Dec 2019

Keywords

  • Blunt abdominal trauma
  • diagnostic, conversion
  • laparoscopy
  • therapeutic
  • trauma

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