Andronikos Karasakalides, MD, Konstantinos Kapoutzis, MD, Evangelia Michalopoulou, MD. Giannitsa General hospital, Giannitsa Greece.
Diagnostic laparoscopy is widely used for assessment and treatment of an assortment of surgical illnesses including critically ill patients.
We retrospectively reviewed 58 cases from 2009 – 2012 who presented with an acute abdomen and had equivocal findings on abdominal CT and/or ultrasound. These patients underwent diagnostic laparoscopy using the classic three port technique or with a single umbilical incision.
Single incision diagnostic laparoscopy was performed in 37 patients. The remaining 21 patients had diagnostic laparoscopy using three separate abdominal incisions. The average operating time was 27 minutes. Of the 58 cases, positive laparoscopic findings were found in 9 cases. Of these 9 cases, 7 were performed using the single umbilical incision and 2 cases using the three ports. Conversion to open laparotomy was required in 3 of these 9 cases. The remaining 6 patients went on to have a therapeutic laparoscopy procedure. The findings on laparoscopy were : 3 cases of mesenteric ischemia, 2 cases with meckel’s diverticulitis, 2 cases of appendicitis, 1 case with an appendiceal abscess, and 1 case with a foreign body with perforation into the mesentery.
Single incision laparoscopy as a diagnostic and as a therapeutic tool can be performed on patients who present with signs of an acute abdomen. It is particularly useful in equivocal cases and the results are similar to other laparoscopic techniques which use multiple ports.