Laparoscopic Peritoneal Repair for Stab Injury

Abstract

The following three patients with stab injuries of abdomen were hemodynamically stable; physical examination of their abdomens revealed no diffuse peritoneal irritation. Computed tomographic scans of their abdomens showed penetration of the fascia and the presence of free fluid without definite intra-abdominal organ injury. Diagnostic laparoscopy was performed in those patients and demonstrated no intra-abdominal organ injury except for peritoneal laceration. Laparoscopic techniques of peritoneal repair are described as follows: 1. A 24-year-old woman with significant two stab injuries in the upper abdomen (left lower chest wall, 1.5 cm long, and right upper quadrant, 2.5 cm long) underwent laparoscopic primary repair of peritoneum. Intracorporeally simple suturing with Vicryl 3-0 were performed on peritoneal lacerations (Video 1). 2. A 32-year-old man with stab injury (2.7 cm long) in the right upper quadrant underwent laparoscopic primary repair of the peritoneum with barbed sutures. The peritoneal laceration was continuously sutured with knotless, unidirectional, barbed monofilament absorbable sutures (V-Loc; Video 2). 3. A 50-year-old woman with a stab injury (1.2 cm long) in the right upper quadrant underwent surgery under laparoscopic view. The suture passer was pulled through each fascia margin of the wound so that the end of each prepared suture rested in the abdominal cavity. On the injured fascia, a knot was extracorporeally tied, and peritoneal repair was completed (Video 3).