The role of laparoscopy in abdominal trauma: a comprehensive diagnostic and therapeutic approach

Laparoscopic surgery has significantly improved surgical outcomes in several areas of abdominal surgery. Laparoscopy is increasingly being used as a diagnostic tool for the diagnosis and therapeutic intervention of abdominal trauma. Laparoscopic techniques have been widely accepted by surgeons. This study aimed to explore the diagnostic and therapeutic significance of laparoscopic surgery in patients with abdominal trauma. This retrospective study included 65 patients with abdominal trauma who underwent surgery. Five patients (7.69%) underwent direct laparotomy, while 60 patients underwent laparoscopic surgery following diagnostic laparoscopy. The surgeries were performed between January 2010 to May 2019 at Shanghai East Hospital and the Affiliated Taishan Medical College Hospital. We retrospectively reviewed 65 consecutive patients with abdominal trauma who had undergone surgical evaluation. In 5 (7.69%) cases, laparotomy was performed directly. Diagnostic laparoscopy was performed on 60 patients. Among these, 23 (38.33%) cases during laparoscopic surgery had no injury, and 27 (45.00%) were treated by laparoscopically for observed injury. 10 (16.66%) cases were converted to laparotomy. Thus, total laparotomies (direct + converted) were 15/65 (23.07%). Postoperative complications occurred in 2 (3.08%) cases (surgical site infection and subphrenic abscess). Results of 65 patients after operation were analyzed with a median follow-up of 10 months (range 2–48). All patients were discharged successfully. During the follow-up period, no complications arise and reoperation was not needed. In patient with abdominal trauma who are hemodynamically stable, laparoscopy is a minimally invasive, safe, effective, feasible, and reliable technique. Diagnostic laparoscopy reduces the rate of negative laparotomy and offers advantages including lower morbidity, fewer postoperative complications, and shorter hospital stay.