Minilaparoscopy in penetrating abdominal trauma emergency room procedure with local anesthesia.
Keywords:
penetrating abdominal trauma, minilaparoscopiaAbstract
BACKGROUND: there are a number of unnecessary laparotomies in penetrating trauma, wlth a non worthless percentage of complications. When the peritoneal injury is identifled, surgical exploration of the abdomen should be evaluated.
OBJECTIVE: evaluate the penetration of the peritoneum, using a diagnose methocl with direct vision.
SETTING: Hospital de Urgencias de Córdoba. Trauma Hospital.
DESIGN: 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 metting.
POPULATION: Patient with penetrating abdominal trauma, treated between May 2004 to January 2005, with doubtful diagnose of peritoneal violation.
METHOD: under sedation and local anaesthesia, a 5 millimetres laparoscope with 90 grees 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 víscera 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.
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