Feasibility and safety of laparoscopy in acute non-traumatic emergency abdominal surgery: A prospective study

Abstract

Introduction: The use of laparoscopy in emergency abdominal surgery is considered high-risk due to its elevated morbidity, requiring expertise in laparoscopic surgery. Objective: Assessing the feasibility, reproducibility, and safety of laparoscopy in non-traumatic acute abdominal surgery. Methods: Descriptive, prospective and evaluative study, conducted between February 2018 and October 2021. We have included in this study: acute appendicitis and its complications, lithiasis acute cholecystitis (LAC), peritonitis by perforation of peptic ulcer, adhesive acute intestinal obstruction, adnexal torsion, extra-uterine pregnancies, and non-specific acute abdominal pain. Results: We operated on 337 patients laparoscopically, with an average of 02 surgeries per medical shift. In 62.6%, surgeries were performed outside of regular working hours. We encountered temporary, material, and human difficulties in 10.8% of the cases. Average age of the patients is 38 years ±15 years. F/H sex ratio =1.29. Diagnostic accuracy of laparoscopy was 100 %. Intraoperative laparoscopic scanning corrected the preoperative diagnosis in 15.73% of cases. Average operative time was 52.09 min ± 24.14 min. One conversion recorded (0.3%). Rate of postoperative complications was 6.2%. These complications are classified at grade I according to the Clavien-Dindo classification in 85.71%. Only one patient (0.3%) required a second operation. Average length of overall hospitalization was 1.5 days. Conclusion: Our results suggest that emergency laparoscopy is feasible, safe, and reproducible. So it can claim to replace laparotomy in the management of acute, non-traumatic abdominal emergencies.