Volume : V, Issue : VII, July - 2016

The role of laparoscopy in abdominal traumareview of the literature

Surendra K Kala, Ravi K Mathur

Abstract :

 The introduction of intracavitory videoscopic technology led to a tremendous expansion of indication for minimal access procedure in all field of surgery including abdominal trauma. The laparoscopy has become an indispensable diagnostic tool in treatment of both blunt and penetrating traumatic injuries. Laparoscopy has been shown to be valuable in detecting occult diaphragmatic injuries in location where computed tomography (CT) scanning and diagnostic lavage have recognized limitation. It has also minimized unnecessary laparotomy. The liver and spleen injuries were treated conservatively by draining the hemoperitonum with spraying of hemolock solution at the injury site, which promoted haemostasis and stopped oozing. Bleeding was controlled by use of clips, cauterization, ligasure. Mesenteric tear, perforation of small intestine were treated by suturing, stapling, if segmental resection of bowel is needed, hand assisted mini laparotomy was done by extending the umbilical incision. The most important advantage of this technology is reduction of morbidity, shortening of hospitalization and cost effectiveness. It has proved to be robust alternative to conservative treatment or laparotaomies in abdominal trauma and hemoperitoneum patient, who are hemodynamically stable. In future, new development in laparoscopy equipment and the introduction of computer technology including robotic devices are expected to have decisive influence on the treatment of trauma patients. The aim of this study was to assess the mode of injuries, incidence of organ involvement, potential to treat injuries such as small bleeding, liver tear, diaphragmatic tear etc. to reduce the incidence of negative laparotomy. In our series of 40 patents, who were hemodynamically stable, 20 patients (50%) were managed conservatively and 12 patients were treated operatively (30%), after diagnostic laparoscopy, 8 patients (20%) needed open laparotomy. It was concluded that diagnostic/therapeutic laparoscopy has reduced the number of negative laparotomy. After the procedure patients took oral fed early, much sooner mobilization of patients, shortened hospital stay, resume of work early and above all, the procedure also proved cost effective.

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Article: Download PDF   DOI : 10.36106/ijsr  

Cite This Article:

Surendra K Kala, Ravi k Mathur The role of laparoscopy in abdominal traumareview of the literature International Journal of Scientific Research,Volume : 5 | Issue : 7 | July 2016

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