Efficacy of routine laparoscopy for the acute abdomen

Chung, Raphael S.; Díaz, José Luis Rodríguez; Chari, V.

doi:10.1007/s004649900638

Cited by 54 publications

(48 citation statements)

References 11 publications

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“…Many acute gynecological diseases can be approached safely and effectively with laparoscopy, with the aim not only to correctly diagnose the diseases but also to treat them (LE 4) [121][122][123][124][125][126][127][128][129][130][131][132].…”

Section: Gynecologic Disordersmentioning

confidence: 99%

“…A cystectomy is recommended as opposed to a unilateral salpingooophorectomy in reproductive-aged women. Laparoscopic evaluation is usually feasible; however, if cancer is suspected, laparotomy may be necessary to ensure complete removal and for staging purposes (LE 5) [121]. Laparoscopic surgery advantages over laparotomy include shorter hospital stay without increased adverse events (LE 2b) [175].…”

Section: Gynecologic Disordersmentioning

confidence: 99%

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Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

et al. 2012

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Background In January 2010, the SICE (Italian Society of Endoscopic Surgery), under the auspices of the EAES, decided to revisit the clinical recommendations for the role of laparoscopy in abdominal emergencies in adults, with the primary intent being to update the 2006 EAES indications and supplement the existing guidelines on specific diseases. Methods Other Italian surgical societies were invited into the Consensus to form a panel of 12 expert surgeons. In order to get a multidisciplinary panel, other stakeholders involved in abdominal emergencies were invited along with a patient's association.

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Section: Gynecologic Disordersmentioning

confidence: 99%

Section: Gynecologic Disordersmentioning

confidence: 99%

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

et al. 2012

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“…Abschlieûend ist ein Fascienverschluss im Bereich aller Trokareinstiche > 5 mm obligat durchzuführen. [6,7]. Eine eingehendere Betrachtung dieser Themen ist jedoch nicht Aufgabe der vorliegenden Übersicht.…”

Section: Laparoskopische Technikunclassified

“…Allerdings ist bei der Diagnose akuter Darmverschluss anhand der vorliegenden Daten und auch der eigenen Erfahrungen davon auszugehen, dass ein laparoskopisches Vorgehen auch bei selektionierten Patienten nur in etwa 50±70 % erfolgreich ist (Tabelle 2) und somit zweifellos die höchste Konversionsrate aller laparoskopischen Operationsverfahren aufweist. ¾hnlich hohe Konversionsraten finden sich formal nur beim akutem Abdomen unklarer ¾tiologie [6,7]. Hier liefert die Laparoskopie allerdings wertvolle diagnostische Informationen, die für die Optimierung des konventionell chirurgischen Vorgehens sinnvoll genutzt werden können.…”

Section: Laparoskopische Technikunclassified

Laparoskopie bei Dünndarmileus

Neufang

Becker

2000

Chirurg

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Today laparoscopic procedures are routinely performed in patients with intestinal adhesions from previous abdominal surgery. Does laparoscopy have a potential benefit in acute small-bowel obstruction? Theoretically, a lower rate of wound complications and incisional hernias, as well as less subsequent adhesions with a lower incidence of recurrent intestinal obstruction, can be expected. However, laparoscopy is successful in only 50-70% of selected patients, thereby representing the highest rate of conversion in minimally invasive surgery. Laparoscopic management of severe abdominal distension with massively dilated and fragile small-bowel or dense adhesions is extremely difficult even when performed by experienced surgeons. Significantly prolonged operating time, the high risk of bowel injury (> 6-10%) and an increased frequency of early reoperations jeopardize the patient's safe outcome. However, in strictly selected patients the laparoscopic approach may be promising. In acute intestinal obstruction without a history of previous abdominal surgery, laparoscopy is--in the absence of adhesions--an excellent diagnostic tool and may also be a successful therapeutic modality in a variety of bowel-obstruction etiologies. Furthermore, the laparoscopic option should be considered in patients who previously had undergone small laparotomies (e.g., appendectomy) or laparoscopic surgery. We recommend "postlaparoscopic" intestinal obstruction as the ideal case for laparoscopic reexploration. Incarcerated hernias at the site of trocar insertion or adhesions due to peritoneal tears are easily identified as the cause of obstruction and successfully cured with the laparoscope. In conclusion, we advocate the laparoscopic approach in acute small-bowel obstruction exclusively for selected patients. Clinical studies are required to define appropriate surgical indications objectively.

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“…Although diagnostic laparoscopy may be safely applied for the diagnosis of blunt or penetrating abdominal injuries in hemodynamically stable patients [74][75][76][77][78], it appears to be of questionable value in the diagnosis of retroperitoneal traumatic pathology [74].…”

Section: Diagnostic Laparoscopymentioning

confidence: 99%