ROLE OF LAPAROSCOPY IN BLUNTABDOMINAL TRAUMA

Abstract

Background: Treatment of blunt abdominal trauma requires a precise diagnosis that is not always possible with imaging techniques. The introduction of laparoscopic technique is increasingly used alternative to open surgery. Diagnostic laparoscopy with therapeutic option in stable patients is an emerging technique. Objective: To assess the efficacy of laparoscopy and its role in patients with blunt abdominal trauma. Patients and methods: 40 hemodynamically stable patients with suspicious abdominal injuries underwent diagnostic or therapeutic laparoscopy at the trauma service of Zagazig University Hospital. Inclusion criteria: hemodynamically stable patients with suspicious abdominal injuries. Exclusion criteria: penetrating abdominal trauma, marked hemodynamic instability, Patients with increased intracranial tension and Patients with general or local contra-indications for laparoscopy. Operative technique: creation of Pneumoperitonium with placement of three ports, one 10-mm for the telescope and two 5-mm trocars. If necessary, accessory trocars were inserted. A thorough exploration of the abdominal cavity was carried out. The hemoperitoneum or bowel contents were aspirated, and the lesion causing the injury was located and manged, If possible. Conversion to laparotomy was decided in cases of nonsatisfactory or incomplete abdominal examination Statistical analysis: SPSS version 15. Results: laparoscopic mangement showed results better than that of open exploration as regard postoperative pain, operative time, hospital stay and most of complications. Conclusion: Laparoscopic mangemant of haemodynamically stable blunt trauma is a promising solution which needs increasing its learning curve for optimum results.
Keywords: blunt – trauma - laparoscopic.