• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Descriptions and Video Updates
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • COVID-19 Announcements
    • SAGES 2021 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 The Next Big Thing (Formerly Emerging Technology) Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • COVID-19 Annoucements
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

Laparoscopy in penetrating trauma is a safe and effective alternative to laparotomy

Vadim Meytes, DO, Grace Chang, Kevin Bain, DO, Michael Timoney, MD. NYU Langone Hospital – Brooklyn

Introduction: Diagnostic laparoscopy (DL) is an increasingly used modality when approaching penetrating anterior abdominal injury (PAAI). Historically, exploratory laparotomy (EL) for PAAI can result in a 20% negative laparotomy, 5% mortality and 20% morbidity rate. Laparoscopically trained trauma surgeons can utilize a minimally invasive technique to quickly assess for intra-abdominal organ injury in hemodynamically stable patients. In the hands of a skilled surgeon, PAAI with a confirmed injury can be repaired through therapeutic laparoscopy (TL) or EL without delay in treatment. This study analyzes the safety and efficacy of using DL as a first line therapy for hemodynamically stable patients with PAAI.

Methods: Between December 2006 and September 2016, 56 patients underwent DL after presenting to NYU Langone Hospital – Brooklyn Emergency Room with PAAI. A retrospective analysis was conducted to analyze protocol and treatment outcomes. Variables reviewed included Glasgow Coma Scale (GCS), Injury Severity Scale (ISS), FAST exam and/or CT scan results, length of stay (LOS), and postoperative complications. Based on outcomes, patients were categorized into three groups: DL, DL with progression to TL, and DL with conversion to EL.

Results: In the study period, a total of 94 patients presented with PAAI that went to the OR, 56 of which were initially treated laparoscopically. Causes of injury included stab wounds, gunshot wounds, traffic accidents, and self-inflicted injuries. The mean age was 40 ± 12 years.  The mean GCS was 14 ± 2, and the mean ISS was 4 ± 4.  Of the 56 patients who underwent DL, 25 patients (44.6%) required no further intervention (group 1), 21 patients (37.5%) underwent TL (group 2), and 10 patients (17.8%) required EL (group 3). Mean LOS for groups 1, 2 and 3 were 4 ± 3.3 days, 3 ± 1.9 days and 6 ± 4.5 days, respectively. There were no missed injuries or postoperative complications requiring the OR in all groups. TL included diaphragm laceration repairs, control of hepatic laceration and primary bowel repair.

Conclusion:  Diagnostic Laparoscopy should be considered first line for hemodynamically stable patients with PAAI with equivocal FAST and/or CT scan findings. Eighty-two percent of our patients did not require conversion to EL. This allowed for decreased postoperative pain, quicker recovery time, and shorter hospital stays. When in the hands of laparoscopically trained trauma surgeons, these patients can be quickly and safely treated while avoiding any delays in diagnosis.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87420

Program Number: S069

Presentation Session: Acute Care Session

Presentation Type: Podium

Post Views: 16

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2018 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc