Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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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).


Abstract

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.


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