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Use of laparoscopy in trauma at a level II trauma center
Authors:Barzana Daniel C  Kotwall Cyrus A  Clancy Thomas V  Hope William W
Affiliation:South East Area Health Education Center, Department of Surgery, New Hanover Regional Medical Center, Wilmington, North Carolina, USA.
Abstract:

Background and Objectives:

Enthusiasm for the use of laparoscopy in trauma has not rivaled that for general surgery. The purpose of this study was to evaluate our experience with laparoscopy at a level II trauma center.

Methods:

A retrospective review of all trauma patients undergoing diagnostic or therapeutic laparoscopy was performed from January 2004 to July 2010.

Results:

Laparoscopy was performed in 16 patients during the study period. The average age was 35 years. Injuries included left diaphragm in 4 patients, mesenteric injury in 2, and vaginal laceration, liver laceration, small bowel injury, renal laceration, urethral/pelvic, and colon injury in 1 patient each. Diagnostic laparoscopy was performed in 11 patients (69%) with 3 patients requiring conversion to an open procedure. Successful therapeutic laparoscopy was performed in 5 patients for repair of isolated diaphragm injuries (2), a small bowel injury, a colon injury, and placement of a suprapubic bladder catheter. Average length of stay was 5.6 days (range, 0 to 23), and 75% of patients were discharged home. Morbidity rate was 13% with no mortalities or missed injuries.

Conclusions:

Laparoscopy is a seldom-used modality at our trauma center; however, it may play a role in a select subset of patients.
Keywords:Laparoscopy   Trauma   Therapeutic   Diagnostic
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