The laparoscopic approach in abdominal emergencies: has the attitude changed?

Abstract

We believe that laparoscopy is not an alternative to physical examination/good clinical judgment or to conventional noninvasive diagnostic methods in treating the patient with symptoms of an acute abdomen. However it must be considered an effective option in treating patients in whom these methods fail and as a challenging alternative to open surgery in the management algorithm for abdominal emergencies.

Post‐Hospital Discharge Venous Thromboembolism in Colorectal Surgery

“…As previously mentioned, critically ill patients who underwent emergent abdominal surgery with mesenteric ischemia and colonic perforation more commonly experience post-discharge VTE (Table 4); however, it is difficult to quantify the potential benefits of laparoscopy in these situations. Although the feasibility of laparoscopic surgery in abdominal emergencies has been reported [21][22][23], further studies are required to compare benefits and disadvantages of laparoscopic surgery in abdominal emergencies. In addition, our study results show that some colorectal procedures such as total colectomy have significantly higher rate of post-discharge VTE events compared to less extensive colorectal procedures such as colostomy closure, and these findings are unrelated to the patient's diagnosis (e.g., IBD).…”

Estimation of the capacity of emergency surgery in Konya: Nine-year multicenter study

“…As reported above, strangulated hernia ranked high among surgical emergencies, with a rate of 10-25% (11)(12)(13)(14). In the present study, its frequency was 15% in university hospitals.…”

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)

“…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].…”

“…However, DL is better than US (LE 2b) [123,128,130,133,138] and may lead to the modification of an incorrect preoperative diagnosis in up to 40 % of cases (LE 4) [124,128,130,139,140]. Early DL results in the accurate, prompt, and efficient management of acute abdominal pain, particularly in general practice, where it reduces the rate of unnecessary laparotomy and right iliac fossa gridiron incisions and increases diagnostic accuracy (LE 4) [122,123,[125][126][127]. In particular, DL has been shown to reduce the risk of a negative appendectomy when appendicitis is suspected, with a stronger effect in fertile women, mainly due to the correct diagnosis of gynecological disorders (LE 1a) [98,141].…”