الفهرس | Only 14 pages are availabe for public view |
Abstract Dealing with a patient with abdominal trauma requires understanding of the mechanism of injury, the common injury patterns and types of injuries identified with trauma. Early identification of significant intra-abdominal injuries is necessary for the successful management of trauma, because delay in diagnosis can lead to significant morbidity and mortality. In spite of the various diagnostic methods currently used (Diagnostic Peritoneal Lavage, Abdominal U/S and C.T. scan), it is difficult to evaluate the presence and severity of intra-abdominal injuries. Emergency laparoscopy is the laparoscopic operation which shoud be performed without any delay in life threatening situations and it should be done by a specialist laparoscopic surgeon and he should be able to perform laparoscopic surgery, once pathology is diagnosed inside the abdomen. Therapeutic applications will progress with increasing diagnostic familiarity, improvement in the surgeon’s laparoscopic skills and developing technologic advances in trauma management. On the basic of laparoscopic findings, laparoscopy may be enough in patients with abdominal trauma gastric wall repair, small bowel repair, small bowel resection-anastmosis, ligation of bleeder in the mesentry, sigmoid colon repair, Hartman’s procedure, cholecystectomy, distal pancreatectomy and splenectomy. The surgeon must have adequate training and experience in the laparoscopic surgery before intending to perform any procedure independently. He shoud be familier with the equipment instrument and energy source. The outcome of any laparoscopic procedure greatly depend on the experience of the surgeon. Conclusion: Diagnostic and therapeutic laparoscopy applied to carefully selected hemodynamically stable trauma patients proved to be safe and technically feasible. It also reduced the negative and non therapeutic laparotomies and offered profound therapeutic potential and cost effectiveness. |