Laparoscopy in Abdominal Emergencies. Romanian Association for Endoscopic Surgery Consensus. Part I (Trauma).

Abstract

Background: laparoscopy has emerged as a pivotal tool for the management of acute abdominal pathologies. It provides diagnostic and therapeutic advantages, enabling surgeons to evaluate and address diverse acute abdominal conditions using minimally invasive techniques. The aim of this consensus was to obtain evidence-based guidance for surgeons regarding the utilization of laparoscopy in emergency medical settings, and has been divided into trauma and non-trauma emergencies. This is the part dedicated for trauma. Material and Methods: the task forces of the RAES Research Committee and a panel of experts were established. The development of consensus statements started with an extensive literature review of available medical databases (PubMed, Cochrane, and EMBASE). A set of questions addressing major issues related to the use of laparoscopy in trauma and non-trauma emergencies was defined. The validation of the questions set was performed by the expert group through the first Delphi round. Consensus statements and recommendations were also obtained. The quality of evidence and recommendation strength were rated using the GRADE system. The recommendations were formulated in a directive manner and then assessed by an expert panel using the Delphi technique for agreement. Results: the two main types of emergencies were trauma and non-trauma. There were seven recommendations for the trauma section. For each statement, agreement from the expert panel was obtained. The statements included training for surgeons involved in trauma care, indications and contraindications for laparoscopy in trauma cases, and conversions and complications of laparoscopy for trauma. Conclusions: the RAES consensus offers a set of guidelines for surgeons managing acute abdominal conditions using laparoscopic techniques.