[Minilaparoscopy in penetrating abdominal trauma emergency room procedure with local anesthesia].
BACKGROUND
There are a number of unnecessary laparotomies in penetrating trauma, with a non worthless percentage of complications. When the peritoneal injury is identified, surgical exploration of the abdomen should be evaluated.


OBJECTIVE
Evaluate the penetration of the peritoneum, using a diagnose method with direct vision.


METHODS
Hospital de Urgencias de Córdoba. Trauma Hospital.


METHODS
To evidence peritoneum trespassing, laparoscopy was performed with local anaesthesia in patients with penetrating abdominal trauma without signs of abdominal injury in the imaging methods and doubts in the physical examination, in a prospective setting.


METHODS
Patient with penetrating abdominal trauma, treated between May 2004 to January 2005, with doubtful diagnose of peritoneal violation.


METHODS
Under sedation and local anaesthesia, a 5 millimetres laparoscope with 90 degrees vision was placed at umbilicus. The anterior abdominal wall, flanks and diaphragm were exanimate, looking for the peritoneal wound or free fluid.


RESULTS
Laparotomy could be avoided in four patients. In the four remaining, laparoscopy or conventional surgery was performed. Two presented hollow viscera injury, one hemoperitoneo and the other, minimum liver damage. There were not complications in both groups. The average hospital stay of the first group was 13 hours.


CONCLUSIONS
In selected patients, the minilaparoscopy is useful in decreased the percentage of unnecessary laparotomies and general anaesthesia, and its complications.
Ariel
Peralta
P
Servicio de Cirugía General, Hospital Municipal de Urgencias de Córdoba, Catamarca 441. cordoba@cordoba.gov.ar
Sebastián
Vélez
V
Sergio
Locicero
L
Nicolini
Francisco Florez
FF
D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010537:Peritoneum / Q000293:injuries*; D011446:Prospective Studies; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult