الفهرس 
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Abstract
For patients with blunt abdominal trauma (BAT), the role of laparoscopy is even less clear than for those with PAT due to relatively fewer reports. One of the reasons for this is that more treatment options are available for patients with BAT. With advances in imaging and treatment, such as trans-arterial embolization (TAE), non-operative management (NOM) has become the treatment of choice for most hemodynamically stable patients with BAT. On the other hand, emergency laparotomy can be life saving for patients in shock and unresponsive to fluid resuscitation. Laparoscopy, however, could be beneficial in some select situations, such as for patients with isolated intra-abdominal fluid accumulation of uncertain origin shown on computed tomography (CT) scans.There are reports of the use of laparoscopy for blunt bowel perforations, liver injuries, and spleen injuries. Our previous studies suggest the benefits of laparoscopy in avoiding the need of laparotomy for select patients with BAT, except for those with spleen injuries. However, the actual role of therapeutic laparoscopy for patients with BAT remains undefined because the study focused on select indications in a limited number of patients and compared patients using an open approach on the basis of historical cohorts As experience in the use of laparoscopy for abdominal trauma accumulates, the application of laparoscopy for BAT patients has been expanded at our institution The management of blunt abdominal trauma has evolved over time. While laparotomy is the standard of care in hemodynamically unstable patients, stable patients are usually treated by non-operative management (NOM), incorporating adjuncts such as interventional radiology. However, although NOM has shown good results in solid organ injuries, other lesions, namely those involving the hollow viscus, diaphragm, and mesentery, do not qualify for this approach and need surgical exploration.Laparoscopy can substantially reduce additional surgical aggression.Ithas both diagnostic and therapeutic potential and, when negative, may reduce the number of unnecessary laparotomies. Although some studies have shown promising results on the use of laparoscopy in blunt abdominal trauma, randomized controlled studies are lacking. Laparoscopy requires adequate training and experience as well as sufficient staffing and equipment.