Vantaggi e limiti dell'approccio laparoscopico nell'addome acuto

Giorgio Romano, Giuseppe Buscemi, Danilo Turco, Fiorella Calderone, Francesco Moscato

Research output: Contribution to conferenceOther

Abstract

[automatically translated] INTRODUCTION AND OBJECTIVES The pathological conditions that can arise with a picture of acute abdomen are very numerous and their recognition, despite the refinement of diagnostic procedures, always represents a difficult test for even the most experienced surgeon. Thanks to the standardization of procedures and the use of high technology laparoscopy is always today more guidance to solve diagnostic doubts, even in emergency. MATERIALS AND METHODS: The authors report our experience of laparoscopic approach of 147 patients, all of hemodynamically stable patients with a diagnosis of acute abdomen input. RESULTS In 59% of cases the laparoscopic treatment was used to diagnose and treat the underlying disease (intestinal obstruction by the bridle, acute appendicitis, acute cholecystitis, gastroduodenal perforation); in 28% of cases it was useful, it faced with the necessity of a conversion, to choose the path more convenient access laparotomy; in 13% of cases it was unsuccessful imposing an exploratory laparotomy. CONCLUSION Based on our experience, in 77% of cases of acute abdomen minimally invasive technique allowed under some circumstances to confirm the preoperative diagnosis, in other reformulate intraoperatively, and in most patients make a curative treatment, avoiding the exploratory laparotomy "white" by localizing the lesion site, optimizing the post-operative course, reducing days of hospitalization, with elimination of health and social costs. The disadvantages of laparoscopy in emergency are represented by a greater invasiveness than other diagnostic procedures, by higher operating room related to the use of a disposable instrumentation costs, the need for a surgical team with adequate training to ensure safety and speed in execution of the laparoscopic approach. We therefore believe, based on experience we have gained, which in the context of classification and diagnosis of acute abdomen therapeutic planning the laparoscopic approach has its concrete utility, representing the latest diagnostic time and the first time above the therapeutic in cases where the clinical diagnosis remains undetermined. the need for a surgical team with adequate training to ensure safety and speed in the execution of the laparoscopic approach. We therefore believe, based on experience we have gained, which in the context of classification and diagnosis of acute abdomen therapeutic planning the laparoscopic approach has its concrete utility, representing the latest diagnostic time and the first time above the therapeutic in cases where the clinical diagnosis remains undetermined. the need for a surgical team with adequate training to ensure safety and speed in the execution of the laparoscopic approach. We therefore believe, based on experience we have gained, which in the context of classification and diagnosis of acute abdomen therapeutic planning the laparoscopic approach has its concrete utility, representing the latest diagnostic time and the first time above the therapeutic in cases where the clinical diagnosis remains undetermined.
Original languageItalian
Pages41-42
Number of pages2
Publication statusPublished - 2008

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