title: Laparoscopy in Abdominal Trauma.
abstract: BACKGROUND
  The decision in favor of surgery or nonoperative conservative treatment in blunt and penetrating abdominal trauma requires a precise diagnosis that is not always possible with imaging techniques, whereby there is great danger that an injury to the diaphragm or intestines may be overlooked. To avoid such oversights, indications for exploratory laparotomy have traditionally been generous, to the extent that up to 41% of exploratory laparotomies turn out to be nontherapeutic and could be, or could have been, avoided with laparoscopy.
  
  
  METHODS
  A diagnostic laparoscopy with therapeutic option should only be attempted in stable patients. Three trocars are usually used and the abdomen is explored systematically, beginning with the right upper quadrant and continuing clockwise. Hollow viscus injuries and injuries to the diaphragm and mesentery can be detected and sutured laparoscopically. Injuries to parenchymal organs are not a primary focus of laparoscopy, but with a laparoscopic approach, they usually no longer bleed in stable patients and can be sealed with tissue adhesive and collagen tamponade to prevent re-bleeding.
  
  
  RESULTS
  The routine use of laparoscopy can achieve a sensitivity of 90-100% in abdominal trauma. This can reduce the number of unnecessary laparotomies and the related morbidity.
  
  
  CONCLUSIONS
  Laparoscopy can be performed safely and effectively in stable patients with abdominal trauma. The most important advantages are reduction of the nontherapeutic laparotomy rate, morbidity, shortening of hospitalization, and cost-effectiveness. In the future, new developments in and the miniaturization of equipment can be expected to increase the use of minimally invasive techniques in abdominal trauma cases.
authors.affiliation: Department of Surgery, Medical University Graz, Universitätsklinik für Chirurgie, Graz, Austria. selman.uranues@medunigraz.at.|Department of Surgery, Medical University Graz, Universitätsklinik für Chirurgie, Auenbruggerplatz 29, 8036, Graz, Austria. selman.uranues@medunigraz.at.
authors.forename: Selman
authors.initials: S
authors.lastname: Uranüs
authors.affiliation: Department of Radiology, Medical University Graz, Graz, Austria.
authors.forename: Katrin
authors.initials: K
authors.lastname: Dorr
keywords: Abdominal trauma; Diagnosis of abdominal trauma; Laparoscopy; Therapeutic laparoscopy; Trauma
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