POTENTIAL OF LAPAROSCOPY TO REDUCE NON-THERAPEUTIC TRAUMA LAPAROTOMIES

Standard diagnostic methods used to evaluate patients sustaining abdom inal trauma result in non-therapeutic laparotomy rates ranging from 5 to 40 per cent depending upon the clinical situation. The purpose of t his study was to assess the safety and efficacy of diagnostic laparosc opy in the identification of intra-abdominal injuries in stable trauma patients. Twenty-one hemodynamically stable adult patients underwent laparoscopy prior to laparotomy for blunt (n = 10) or penetrating (n = 11) trauma, and the findings from each procedure were directly compar ed. Laparoscopy was 100 per cent accurate in detecting the need for la parotomy, although a number of specific injuries were not identified. There were no complications related to the procedure. Emergency laparo scopy is safe and should be considered in hemodynamically stable traum a patients with indications for laparotomy based on standard diagnosti c criteria in order to minimize the incidence of non-therapeutic lapar otomy.