Abdominal Trauma and Laparoscopy

  • Vincenzo Mandalà
  • Massimo Lupo
  • Antonino Mirabella
  • Benedetto La Motta
Part of the Updates in Surgery book series (UPDATESSURG)


Laparoscopy has seen considerable progress in recent years; so it is not surprising that its application has been recommended in all abdominal emergencies, whether traumatic or nontraumatic. In truth the idea of a service of minimally invasive surgery began to be used in abdominal emergencies long before laparoscopy really emerged as a surgical technique. In fact since the 1920s peritoneoscopy or coelioscopy was postulated for diagnosing traumatic hemoperitoneum 1, 2.


Abdominal Trauma Diagnostic Laparoscopy Gunshot Wound Stab Wound Tension Pneumothorax 


  1. 1.
    Short AR (1925) The use of coelioscopy. BMJ 2:254–255PubMedCrossRefGoogle Scholar
  2. 2.
    Stone WE (1924) Intra-abdominal examination by the aid of the peritoneoscope. J Kansas Med Soc 24:63–65Google Scholar
  3. 3.
    Beling CA (1941) Selection of cases for peritoneoscopy. Arch Surg 42:872–889CrossRefGoogle Scholar
  4. 4.
    Heselson J (1970) Peritoneoscopy in abdominal trauma. S Afr J Surg 8:53–61PubMedGoogle Scholar
  5. 5.
    Gazzaniga AB, Stanton WW, Bartlett RH (1976) Laparoscopy in the diagnosis of blunt and penetrating injuries to the abdomen. Am J Surg 131:315–318PubMedCrossRefGoogle Scholar
  6. 6.
    Murray JA, Demetriades D, Asensio JA et al (1998) Occult injuries to the diaphragm: prospective evaluation of laparoscopy in penetrating injuries to the left lower chest. J Am Coll Surg 187:626–630PubMedCrossRefGoogle Scholar
  7. 7.
    Ivatury RR, Simon RJ, Stahl WM (1993) A critical evaluation of laparoscopy in penetrating abdominal trauma. J Trauma 34:822–828PubMedCrossRefGoogle Scholar
  8. 8.
    Villavicencio RT, Aucar JA (1999) Analysis of laparoscopy in trauma. J Am Coll Surg 189:11–20PubMedCrossRefGoogle Scholar
  9. 9.
    Uranüs S (2010) Minimally invasive surgery in trauma and emergencies. Eur J Trauma Emerg Surg 36:1CrossRefGoogle Scholar
  10. 10.
    Uranüs S, Dorr K (2010) Laparoscopy in abdominal trauma. Eur J Trauma Emerg Surg 36:19–24CrossRefGoogle Scholar
  11. 11.
    Leppäniemi A, Haapiainen R (2003) Diagnostic laparoscopy in abdominal stab wounds: a prospective, randomized study. J Trauma 55:636–645PubMedCrossRefGoogle Scholar
  12. 12.
    Cuschieri A, Hennessy T, Stephens RB, Berci G (1988) Diagnosis of significant abdominal trauma after road traffic accidents: preliminary results of a multicentre clinical trial comparing minilaparoscopy with peritoneal lavage. Ann Roy Coll Surg 70:153–155Google Scholar
  13. 13.
    Sauerland S, Agresta F, Bergamaschi R et al (2006) Laparoscopy for abdominal emergencies Evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 20:14–29PubMedCrossRefGoogle Scholar
  14. 14.
    Diagnostic Laparoscopy Guidelines: Practice/Clinical Guidelines published on: 11/2007 by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)Google Scholar
  15. 15.
    Sosa JL, Arrillaga A, Puente I et al (1995) Laparoscopy in 121 consecutive patients with abdominal gunshot wounds. J Trauma 39:501–506PubMedCrossRefGoogle Scholar
  16. 16.
    Sosa JL, Baker M, Peunte I et al (1995) Negative laparotomy in abdominal gunshot wounds: potential impact of laparoscopy. J Trauma 38:194–197PubMedCrossRefGoogle Scholar
  17. 17.
    Ortega AE, Tang E, Froes ET et al (1996) Laparoscopic evaluation of penetrating thoracoabdominal traumatic injuries. Surg Endosc 10:19–22PubMedCrossRefGoogle Scholar
  18. 18.
    National Guideline Clearinghouse (2009) Diagnostic laparoscopy for trauma. Guideline summary NGC — 6829 (NCG Status: Update information was verified by the guideline developer on March 9, 2009)Google Scholar
  19. 19.
    Choi YB, Lim KS (2003) Therapeutic laparoscopy for abdominal trauma Surg Endosc 17:421–427Google Scholar
  20. 20.
    Mathonnet M, Peyrou P, Gainant A et al (2003) Role of laparoscopy in blunt perforations of the small bowel. Surg Endosc 17:641–645PubMedCrossRefGoogle Scholar
  21. 21.
    Weinberg JA, Magnotti LJ, Edwards NM et al (2007) “Awake” laparoscopy for the evaluation of equivocal penetrating abdominal wounds. Injury 38:60–64PubMedCrossRefGoogle Scholar
  22. 22.
    Berci G, Dunkelman D, Michel SL et al (1983) Emergency minilaparoscopy in abdominal trauma. An update. Am J Surg 146:261–265PubMedCrossRefGoogle Scholar
  23. 23.
    Stefanidis D, Richardson WS, Lily C et al (2009) The role of diagnostic laparoscopy for acute abdominal conditions: an evidence-based review. Surg Endosc 23:16–23PubMedCrossRefGoogle Scholar
  24. 24.
    Smith RS, Meister RK, Tsoi EKM et al (1993) Laparoscopically guided blood salvage and autotransfusion in splenic trauma: a case report. J Trauma 34:313–314PubMedCrossRefGoogle Scholar
  25. 25.
    Zantut LFC, Machado MAC, Volpe P et al (1996) Autotransfusion with laparoscopically salvaged blood in trauma: report on 21 cases. Surg Laparosc Endosc 6:46–48PubMedCrossRefGoogle Scholar
  26. 26.
    Warren O, Kinross J, Paraskeva P, Darzi A (2006) Emergency laparoscopy — current best practice. World J Emerg Surg 1:24PubMedCrossRefGoogle Scholar
  27. 27.
    Fabian TC, Croce MA, Stewart RM et al (1993) A prospective analysis of diagnostic laparoscopy in trauma. Ann Surg 217:557–565PubMedCrossRefGoogle Scholar
  28. 28.
    Chen RJ, Fang JF, Lin BC et al (1998) Selective application of laparoscopy and fibrin glue in the failure of nonoperative management of blunt hepatic trauma. J Trauma 44:691–695PubMedCrossRefGoogle Scholar
  29. 29.
    Carobbi A, Romagnani F, Antonelli G, Bianchini M (2010) Laparoscopic splenectomy for severe blunt trauma: initial experience of ten consecutive cases with a fast hemostatic technique. Surg Endosc 24:1325–1330PubMedCrossRefGoogle Scholar
  30. 30.
    Hassanen A, Abou-Bieh H, Nagib Y (2009) Laproscopy for the evaluation of anterior abdominal stab wounds in hemodynamically stable patients. EJS 28:58–61Google Scholar
  31. 31.
    Leppäniemi A, Salo J, Haapiainen R (1995) Complications of negative laparotomy for truncal stab wounds. J Trauma 38:54–58PubMedCrossRefGoogle Scholar
  32. 32.
    Matthews BD, Bui H, Harold KL et al (2003) Laparoscopic repair of traumatic diaphragmatic injuries. Surg Endosc 17:254–258PubMedCrossRefGoogle Scholar
  33. 33.
    Smith CH, Novick TL, Jacobs DG, Thomason MH (2000) Laparoscopic repair of a ruptured diaphragm secondary to blunt trauma. Surg Endosc 14:501–502PubMedGoogle Scholar
  34. 34.
    Smith RS, Fry WR, Morabito DJ et al (1995) Therapeutic laparoscopy in trauma. Am J Surg 170:632–637PubMedCrossRefGoogle Scholar
  35. 35.
    Zantut LF, Ivatury RR, Smith RS et al (1997) Diagnostic and therapeutic laparoscopy for penetrating abdominal trauma: a multicenter experience. J Trauma 42:825–831PubMedCrossRefGoogle Scholar
  36. 36.
    Sudakoff GS, Yucel EK, Rosen MP et al (2008) Blunt Abdominal Trauma — ACR Appropriateness Criteria®. Available at: http://www.guidelines.gov/content.aspx?id=15726. Accessed 16 June 2011Google Scholar
  37. 37.
    Dissanaike S, Frezza EE (2006) Laparoscopic splenectomy in blunt trauma. JSLS 10:499–503PubMedGoogle Scholar
  38. 38.
    Lin HF, Wu JM, Tu VC Chen H-A, Shih H-C Value of diagnostic and Therapeutic Laparoscopy for Abdominal Stab Wounds. World J Surg (2010) 34: 1653–1662PubMedCrossRefGoogle Scholar
  39. 39.
    Letoublon C, Chen Y, Arvieux C et al (2008) Delayed celiotomy or laparoscopic as part of the nonoperative management of blunt hepatic trauma. World J Surg 32:1189–1193PubMedCrossRefGoogle Scholar
  40. 40.
    Marzano E, Rosso E, Oussoultzoglou E et al (2010) Laparoscopic treatment of biliary peritonitis following nonoperative management of blunt liver trauma. World J Emerg Surg 5:26PubMedCrossRefGoogle Scholar
  41. 41.
    Kozar RA, Moore FA, Cothren CC et al (2006) Risk factors of hepatic morbidity following non operative management: multicenter study. Arch Surg 141:451–458PubMedCrossRefGoogle Scholar
  42. 41.
    Kozar RA, Moore JB, Niles SE et al (2005) Complications of nonoperative management of blunt hepatic trauma. J Trauma 59:1066–1071PubMedCrossRefGoogle Scholar
  43. 42.
    Marks JM, Youngelman DF, Berk T (1997) Cost analysis of diagnostic laparoscopy vs laparotomy in the evaluation of penetrating abdominal trauma. Surg Endosc 11:272–276PubMedCrossRefGoogle Scholar
  44. 43.
    Simon RJ, Rabin J, Kuhls D (2002) Impact of increased use of laparoscopy on negative laparotomy rates after penetrating trauma. J Trauma 53:297–302PubMedCrossRefGoogle Scholar
  45. 44.
    De Maria EJ, Dalton JM, Gore DC et al (2000) Complementary roles of laparoscopic abdominal exploration and diagnostic peritoneal lavage for evaluating abdominal stab wounds: a prospective study. J Laparoendosc Adv Surg Tech 10:131–136CrossRefGoogle Scholar
  46. 45.
    Velmahos GC, Toutouzas KG (2003) Nonoperative treatment of blunt injury to solid abdominal organs: a prospective study. Arch Surg 138:844–851PubMedCrossRefGoogle Scholar

Suggested Readings

  1. Sauerland S, Agresta F, Bergamaschi R, Borzellino G, Budzynski A, Champault G, Fingerhut A, Isla A, Johansson M, Lundorff P (2006) Laparoscopy for abdominal emergencies. Evidencebased guidelines of the European Association for Endoscopic Surgery. Surg Endosc 20:14–29PubMedCrossRefGoogle Scholar
  2. Agresta F, Ansaloni L, Baiocchi L, Bergamini C, Campanile FB, Carlucci M, Cocorullo G, Corradi A, Franzato B, Lupo M, Mandalà V, Mirabella A, Pernazza G, Piccoli M, Staudacher C, Vettoretto N, Zago M, Lettieri E, Levati A, Pietrini D, Scaglione M, De Masi S, De Placido G, Francucci M, Rasi M, Scaramuzza G, Del Favero AL (2011) Consensus Development Conference of the Società Italiana Chirurgia Endoscopica e nuove tecnologie (SICE); Associazione Chirurghi Ospedalieri Italiani (ACOI); Società Italiana di Chirurgia (SIC); Società Italiana Chirurgia d’Urgenza e Trauma (SICUT), Società Italiana Chirurghi dell’Ospedalità Privata (SICOP) and the European Association for Endoscopic Surgery (EAES). In pressGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Vincenzo Mandalà
    • 1
  • Massimo Lupo
  • Antonino Mirabella
  • Benedetto La Motta
  1. 1.Department of General and Emergency Surgery“Villa Sofia — Cervello” Hospital TrustPalermoItaly

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