This document discusses a study of 50 abdominal trauma cases treated with laparoscopy. Key findings include: - Laparoscopy accurately identified injuries like liver lacerations, splenic injuries, and small bowel perforations. - Laparoscopy avoided the need for laparotomy in 40 cases, allowing non-operative management. - Only 10 cases required conversion to laparotomy for procedures like repair of duodenal transection. - The authors conclude laparoscopy is a better diagnostic tool for abdominal trauma and can treat many cases laparoscopically or with smaller incisions compared to laparotomy.

1. ROLE OF LAPAROSCOPY IN
ABDOMINAL TRAUMA :
A STUDY OF 50 CASES
Dr. ASHISH MOTEWAR
DEPARTMENT OF SURGERY,
GOVERNMENT MEDICAL COLLEGE,
NANDED - MAHARASHTRA

2. INTRODUCTION
COMMONLY USED DIAGNOSTIC MODALITIES
FOR BLUNT ABDOMEN ARE :
- X-RAY
- USG
- CT SCAN
- DIAGNOSTIC PERITONEAL LAVAGE
RECENTLY USED - LAPAROSCOPY

3. MATERIAL AND METHODS

4. MATERIAL AND METHODS
- PERIOD : JAN. 2003 TO NOV. 2004
- NO. OF CASES : 50
- AGE GROUP : 10-50 YRS.
- SEX : MALE- 42, FEMALE- 08
- INVESTIGATIONS : X-RAY
USG

5. MATERIAL AND METHODS
PATIENTS WERE
HAEMODYNAMICALLY STABLE
AND CLINICALLY REQUIRED
EXPLORATION

6. MATERIAL AND METHODS
LAPAROSCOPY :
- 10 MM PORT AT
UMBILICUS
- PNEUMOPERITONEUM
WITH CO2
- 2nd AND 3rd PORTS
INSERTED AS PER REQUIRMENT

7. MATERIAL AND METHODS
BLUNT TRAUMA
30 CASES
PENETRATING INJURIES
20 CASES

8. LAPAROSCOPIC FINDINGS
INJURED CONTUSION LACERATION PERFORATION
ORGAN
1. LIVER 02 03 --
2. SPLEEN 02 05 --
3. DUODENUM 01 -- 01
3. SMALL BOWEL 03 -- 04
4. MESENTRY 05 03 --
5. COLON 02 -- 02
ANTERIOR ABDOMINAL WALL HEMATOMA - 01
RETROPERITONEAL HEMATOMA - 02

9. LIVER : CONTUSION - 02, LACERATION -
03

10. LIVER : CONTUSION - 03, LACERATION -
05

11. SPLEEN : CONTUSION - 02,
LACERATION - 05

12. SPLEEN :
EXPLORATION
WITH SUBCOSTAL
INCISION

13. DUODENUM : TRANSECTION - 01

14. DUODENUM : TRANSECTION - 01

15. ILEUM : PERFORATION- 04

16. ILEUM : CONTUSION- 03

17. ILEUM : CONTUSION- 03

18. ANTERIOR ABD. WALL HEMATOMA - 01

19. LAPAROSCOPIC FINDINGS
INJURED CONTUSION LACERATION PERFORATION
ORGAN
1. LIVER 02 03 --
2. SPLEEN 02 05 --
3. DUODENUM 01 -- 01
3. SMALL BOWEL 03 -- 04
4. MESENTRY 05 03 --
5. COLON 02 -- 02
ANTERIOR ABDOMINAL WALL HEMATOMA - 01
RETROPERITONEAL HEMATOMA - 02

20. SMALL & PROPER INCISION
4
INCHES

21. PERFORATING INJURIES
CASES – 20
PROLAPSED BOWEL /
MESENTRY

22. PERFORATING INJURIES
OBSERVATION
- STOMACH -- 2
- SMALL BOWEL -- 2
- MESENTRY -- 1
- COLON -- 1
- NO INJURY -- 14

23. PERFORATING INJURIES
PRE-OP
POST-OP

24. RESULTS
LAPARATOMIES SAVED - 40
LAPAROTOMY REQUIRED - 10

25. CONCLUSION
- LAPAROSCOPY IS A BETTER MODALITY
FOR DIAGNOSIS AND ASSESSMENT OF
BLUNT INJURY ABDOMEN
- BLUNT ABDOMINAL INJURIES CAN BE
TREATED WITH LAPAROSCOPY
- IF AT ALL LAPAROTOMY IS NEEDED IT
CAN BE DONE WITH SMALL AND
PROPER INCISION