Laparoscopic management of acute abdominal emergencies

Abstract

Laparoscopic management is increasingly recognized as a valuable approach in treating acute abdominal emergencies due to its diagnostic accuracy, minimally invasive approach and therapeutic advantages. It serves as an effective diagnostic tool in unclear abdominal cases, reducing the need for exploratory laparotomies. Key insights from recent literature include the following: Laparoscopic appendicectomy (LA) has been shown to lower wound infection rates and hospital stays compared to open appendicectomy, though the incidence of intra-abdominal abscesses may be slightly higher with LA. Laparoscopy is a safe method for managing acute abdominal pain during pregnancy, especially in cases of appendicitis or cholecystitis, as it minimizes fetal risks and avoids the use of ionizing radiation. Early laparoscopic cholecystectomy, preferably within 72 hours of onset of cholecystitis symptoms, is recommended for quicker recovery and fewer complications. Laparoscopy can be applied in certain trauma cases, although its use is contingent on the surgeon's skill and the patient's stability. It is particularly beneficial in diagnosing gynaecological emergencies such as ectopic pregnancy or ovarian torsion, where rapid diagnosis and treatment can improve outcomes. The success of laparoscopic surgery is highly dependent on the surgeon's expertise. In conditions such as adhesional bowel obstruction or mesenteric ischemia, the evidence is less conclusive, and further clinical trials are needed. In resource-limited settings, the availability of equipment and costs may limit the widespread use of laparoscopic techniques.