Emergent trauma surgery: a narrative review of laparoscopy, thoracoscopy and robotics
Year: 2025
Type: review
Abstract: Background and Objective: Minimally invasive approaches have become integral to the evaluation and management of thoracic and abdominal injuries following advancements in technology, integration with residency training, and an increase in surgeon comfort. Laparoscopy has led to potentially shorter recovery time and fewer complications than traditional open surgery, however, societal guidelines avoid naming the precise indications for laparoscopy in abdominal trauma. Here, we provide a literature review on minimally invasive approaches in trauma with attention to (I) comparing laparotomy vs. laparoscopy; (II) indications and contraindications to minimally invasive approaches; (III) diagnostic sensitivity and specificity; (IV) challenges of laparoscopy; and (V) robotics. Methods: A comprehensive literature search was performed. A total of 1,561 articles were obtained and manually screened for applicability. A total of 22 articles were obtained to provide an evidence-based review on minimally invasive surgery and trauma. Key Content and Findings: With careful patient selection, minimally invasive approaches in thoracic and abdominal trauma may be employed effectively and may avoid larger laparotomy incisions. Some data suggest that the use of laparoscopy may also reduce cost. Hemodynamic stability and mechanism of injury should dictate the choice of minimally invasive approaches. Conclusions: Laparoscopy plays a valuable role in the management of the trauma patient by offering a minimally invasive approach that can facilitate accurate diagnosis and treatment while minimizing surgical trauma and complications. Careful patient selection is vital, and hemodynamic stability is critical when deciding to undergo a minimally invasive approach. A surgeon must be aware of the pitfalls of laparoscopy in trauma, and be prepared to convert to an open operation when indicated. Future advances in technology such as robotics, will continue to provide new techniques and options in emergency general surgery and trauma in the future.
DOI: 10.21037/ales-23-23
Institutions: NYU Langone Health, New York University, Northwell Health
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409436804