Panamerican Journal of Trauma, Critical Care & Emergency Surgery

Register      Login

VOLUME 11 , ISSUE 1 ( January-April, 2022 ) > List of Articles

Original Article

Experiencia De Laparoscopia En Trauma Penetrante En El Hospital General San Juan De Dios

Rudy A Herrera

Keywords : Laparoscopy, Penetrating abdominal trauma, Trauma

Citation Information : Herrera RA. Experiencia De Laparoscopia En Trauma Penetrante En El Hospital General San Juan De Dios. Panam J Trauma Crit Care Emerg Surg 2022; 11 (1):19-21.

DOI: 10.5005/jp-journals-10030-1370

License: CC BY-NC 4.0

Published Online: 24-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: The laparoscopic approach in polytraumatized patients continues to be infrequent. The objective of this study is to analyze our experience of the laparoscopic approach in the patient with hemodynamically stable thoracoabdominal and penetrating abdominal trauma because, in our institution, exploratory laparotomy is the treatment of choice for our patients. Non-therapeutic laparotomies are associated with 5% mortality and 20% morbidity. Material and methods: An observational, descriptive, cross-sectional, and retrospective study was carried out on all patients admitted with abdominal and thoracoabdominal trauma to the San Juan de Dios General Hospital from 2019 to February 2021. Selected all the patients who underwent a laparoscopic approach for diagnostic and therapeutic purposes. Results: Nine patients are described, with a mean age of 31.4 years; 67% of the patients are male. Six patients suffered a stab wound (67%), and conversion to exploratory laparotomy was required in two patients due to findings of complex lesions. In four cases (44%), the laparoscopic examination revealed no lesions. The procedures performed included diaphragmatic repair, transdiaphragmatic pericardial window, and pericardial biopsy. There were no cases of mortality. Conclusion: The laparoscopic approach remains infrequent in trauma patients, its diagnostic and therapeutic utility must be taken into account for selected cases. Its use in the diagnosis of diaphragm injuries due to penetrating abdominal injury in hemodynamically stable patients is widely accepted for its evaluation and repair, as long as they are hemodynamically stable patients and their life is not compromised by performing a minimally invasive procedure. We suggest that it should be carried out by surgeons with experience in the management of polytraumatized patients, who, based on their criteria, can select what type of case will be approached laparoscopically.

PDF Share
  1. Bain K, Meytes V, Chang GC, et al. Laparoscopy in penetrating abdominal trauma is a safe and effective alternative to laparotomy. Surg Endosc 2019;33(5):1618–1625. DOI: 10.1007/s00464-018-6436-1
  2. Sánchez-Arteaga A, Tallón-Aguilar L, Camacho-Marente V, et al. Rol de la laparoscopia en pacientes con traumatismo abdominal. Cir Andal 2019;30(1);124–128.
  3. O'malley E, Boyle E, O'callaghan A, et al. Role of laparoscopy in penetrating abdominal trauma: a systematic review. World J Surg 2013;37(1):113–122. DOI: 10.1007/s00268-012-1790-y
  4. Shih HC, Wen YS, Ko TJ, et al. Noninvasive evaluation of blunt abdominal trauma: prospective study using algorithms to minimize non therapeutic laparotomy. World J Surg 1999;23(3):265–269.
  5. Matsevych OY, Koto MZ, Aldous C. Trauma laparoscopy: A prospect of skills training (cohort study). Int J Surg 2018;55:117–123. DOI: 10.1016/j.ijsu.2018.05.033
  6. Villavicencio RT, Aucar JA. Analysis of laparoscopy in trauma. J Am Coll Surg 1999;189:11–20. DOI: 10.1016/s1072-7515(99)00052-6
  7. Henderson VJ, Organ CH Jr, Smith RS. Negative trauma celiotomy. Am Surg 1993;59:365–370.
  8. Beltzer C, Bachmann R, Strohäker J, et al. Wertigkeit der Laparoskopie beim penetrierenden und stumpfen Abdominaltrauma – ein systematisches review [Value of laparoscopy in blunt and penetrating abdominal trauma-a systematic review]. Chirurg 2020;91(7):567–575. DOI: 10.1007/s00104-020-01158-y
  9. Pau L, Navez J, Cawich SO, et al. Laparoscopic management of blunt and penetrating abdominal trauma: a single-center experience and review of the literature. J Laparoendosc Adv Surg Tech A 2021;31(11):1262–1268. DOI: 10.1089/lap.2020.0552
  10. Zantut LF, Ivatury RR, Smith RS, et al. Diagnostic and therapeutic laparoscopy for penetrating abdominal trauma: a multicenter experience. J Trauma 1997;42:825–829. DOI: 10.1097/00005373-199705000-00012
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.