Emergency minilaparoscopy in abdominal trauma. An update.
In 106 cases of blunt abdominal trauma, the emergency minilaparoscope was used as a diagnostic tool. In 57 patients (53.5 percent), the findings proved to be negative. In 22 patients (20.8 percent), the laparoscopic findings were corroborated by exploration. But, in 27 instances (25.4 percent), minimal to moderate hemoperitoneum was found and the laparoscopic view indicated that these patients could be treated nonoperatively with close observation. None of these patients required subsequent exploration. There were no complications of laparoscopy which required surgical intervention. In our opinion, minilaparoscopy is more diagnostically accurate than lavage. It is a fast and safe examination which can be performed at the bedside with the patient under local anesthesia. The number of unnecessary abdominal explorations in severely injured patients can be reduced to a negligible figure, thus decreasing morbidity, hospitalization time, and costs.