medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2003, Number 3

<< Back Next >>

Cir Gen 2003; 25 (3)

Surgical endoscopy in the trauma patient

Smith S, Fry WR

Language: English
References: 29
Page: 247-254
PDF size: 80.36 Kb.


ABSTRACT

Objective: To review current practice of laparoscopy in the evaluation of patients with suspected thoracoabdominal trauma.
Data collection: Selective review of the literature (29 articles).
Data selection: The most relevant papers dealing with surgical endoscopy in trauma were selected.
Results: Evaluation of patients with suspected abdominal injury continues to challenge the trauma surgeon despite the availability of a variety of noninvasive and invasive diagnostic modalities. Unfortunately, none of the diagnostic tools currently available is a true stand-alone technique, and sound clinical judgment is required to formulate the optimal diagnostic approach for each patient. Frequently, more than one study is required to provide adequate evaluation of a patient with potential abdominal trauma. Laparoscopy has been used sporadically over the past 25 years in the evaluation of abdominal trauma. However, this technique became more widely used in the trauma setting only after the popularity of laparoscopic cholecystectomy made modern videoscopic equipment widely available. Laparoscopy has proved useful in determining the course of anterior abdominal gunshot and stab wounds. In many instances, the wound tracts found in these patients have been demonstrated to be extraperitoneal, and therefore patients were spared a nontherapeutic or negative laparotomy. Ivatury, Fabian, and others have documented laparoscopy as an excellent method for the evaluation of the diaphragm in hemodynamically stable patients who present with penetrating thoracoabdominal wounds. Experience with laparoscopic evaluation of blunt abdominal injury and with therapeutic laparoscopy in the trauma setting is more limited, but several innovative and promising techniques have recently appeared in the literature.
Conclusion: As laparoscopic technology continues to improve and as more trauma surgeons become skilled in videoscopic techniques, utilization of laparoscopy in the evaluation of truncal trauma is certain to increase.


REFERENCES

  1. Esposito TU. Laparoscopy in blunt trauma. Trauma Q 1993; 10: 260-272.

  2. Buzzas GR, Kern SJ, Smith RS, Harrison PB, Helmer SD, Reed JA. A comparison of sonographic examinations for trauma performed by surgeons and radiologists. J Trauma 1998; 44: 604-6; discussion 607-8.

  3. Bode PJ, Niexen RA, van Vugt AB, Shipper J. Abdominal ultrasound as a reliable indicator for conclusive laparotomy in blunt abdominal trauma. J Trauma 1993; 34: 27-31.

  4. Rozycki GS, Ochsner MG, Jaffin JH, Champion HR. Prospective evaluation of surgeons’ use of ultrasound in the evaluation of trauma patients. J Trauma 1993; 34: 516-26; discussion 526-7.

  5. Smith RS, Kern SJ, Fry WR, Helmer SD. Institutional learning curve of surgeon-performed trauma ultrasound. Arch Surg 1998; 133: 530-5; discussion 535-6.

  6. Kern SJ, Smith RS, Fry WR, Helmer SD, Reed JA, Chang FC. Sonographic examination of abdominal trauma by senior surgical residents. Am Surg 1997; 63: 669-74.

  7. Peitzman AB, Makaroun MS, Slasky BS, Ritter P. Prospective study of computed tomography in initial management of blunt abdominal trauma. J Trauma 1986; 26: 585-92.

  8. Meyer DM, Thal ER, Weigelt JA, Redman HC. The role of abdominal CT in the evaluation of stab wounds to the back. J Trauma 1989; 29: 1226-8; discussion 1228-30.

  9. Pal JD, Victoriono GP. Defining the role of computed tomography in blunt abdominal trauma: use in the hemodynamically stable patient with a depressed level of consciousness. Arch Surg 2002; 137: 1029-32; discussion 1032-3.

  10. Gonzalez RP, Ickler J, Gachassin P. Complementary roles of diagnostic peritoneal lavage and computed tomography in the evaluation of blunt abdominal trauma. J Trauma 2001; 51: 1128-34, discussion 1134-6.

  11. Gonzalez RP, Turk B, Falimirski ME, Holevar MR. Abdominal stab wounds: diagnostic peritoneal lavage criteria for emergency room discharge. J Trauma 2001; 51: 939-43.

  12. Kearney PA Jr, Vahey T, Burney RE, Glazer G. Computed tomography and diagnostic peritoneal lavage in blunt abdominal trauma. Their combined role. Arch Surg 1989; 124: 344-7.

  13. Meyer DM, Thal ER, Weigelt JA, Redman HC. Evaluation of computed tomography and diagnostic peritoneal lavage in blunt abdominal trauma. J Trauma 1989; 29: 1168-70; discussion 1170-2.

  14. Fabian TC, Croce MA, Stewart RM, Pritchard FE, Minard G, Kudsk KA. A prospective analysis of diagnostic laparoscopy in trauma. Ann Surg 1993; 217: 557-64; discussion 564-5.

  15. Ivatury RR, Simon RJ, Stahl WM. A critical evaluation of laparoscopy in penetrating abdominal trauma. J Trauma 1993; 34: 822-7; discussion 827-8.

  16. Smith RS, Fry WR, Morabito DJ, Koehler RH, Organ CH Jr. Therapeutic laparoscopy in trauma. Am J Surg 1995; 170: 632-6; discussion 636-7.

  17. Smith RS. Cavitary endoscopy in trauma: 2001. Scand J Surg 2002; 91: 67-71.

  18. Ivatury RR, Simon RJ, Weksler B, Bayard V, Stahl WM. Laparoscopy in the evaluation of the intrathoracic abdomen after penetrating injury. J Trauma 1992; 33: 101-8; discussion 109.

  19. Ivatury RR. Commentary on Video thoracoscopy expedites the diagnosis and treatment of penetrating diaphragmatic injuries. Surg Endosc 2001; 15: 33.

  20. Smith RS, Fry WR, Tsoi EK, Henderson VJ, Hirvela ER, Koehler RH, et al. Gasless laparoscopy and conventional instruments. The next phase of minimally invasive surgery. Arch Surg 1993; 128: 1102-7.

  21. Chin AK, Eaton J, Tsoi, EK, Smith RS, Fry WR, Henderson VJ, et al. Gasless laparoscopy using a planar lifting technique. J Am Coll Surg 1994; 178: 401-3.

  22. Zantut LF, Ivatury RR, Smith RS, Kawahara NT, Porter JM, Fry WR, et al. Diagnostic and therapeutic laparoscopy for penetrating abdominal trauma: a multicenter experience. J Trauma 1997; 42: 825-9; discussion 829-31.

  23. Henderson VJ, Smith RS, Fry WR, Morabito D, Peskin GW, Barkah H, et al. Cardiac injuries: analysis of an unselected series of 251 cases. J Trauma 1994; 36: 341-8.

  24. Hirai S, Hamanaka Y, Mitsui N, Isaka M, Kobayashi T. Successful emergency repair of blunt right atrial rupture after a traffic accident. Ann Thorac Cardiovasc Surg 2002; 8: 228-30.

  25. Ochsner MG, Lowery RC, Frankel HL, Chanpion HR. Thoracoscopy: technical details and application. Trauma Q 1993; 10: 301-311.

  26. Smith RS, Fry WR, Tsoi EK, Morabito DJ, Koehler RH, Reinganum SJ, et al. Preliminary report on videothoracoscopy in the evaluation and treatment of thoracic injury. Am J Surg 1993; 166: 690-3; discussion 693-5.

  27. Wong MS, Tsoi EK, Henderson VJ, Hirvela ER, Forest CT, Smith RS, et al. Videothoracoscopy an effective method for evaluating and managing thoracic trauma patients. Surg Endosc 1996; 10: 118-21.

  28. Fickling WE, Wallace MB. Endoscopic ultrasound and upper gastrointestinal disorders. J Clin Gastroenterol 2003; 36: 103-10.

  29. Zanchetta M, Rigatelli G, Onorato E. Intracardiac echocardiography and transcranial Doppler ultrasound to guide closure of patent foramen ovale. J Invasive Cardiol 2003; 15: 93-6.




2020     |     www.medigraphic.com