• Pascal Fabiani, Antonio Iannelli, Davide Mazza, Anne-Marie Bartels, Nicolas Venissac, Patric Baqué, and J Gugenheim.
• Service de Chirurgie Digestive, Hôpital Archet 2, Nice, France. chir-digestive@chu-nice.fr
• J Laparoendosc Adv Surg Tech A. 2003 Oct 1;13(5):309-12.

BackgroundAt present, laparoscopy is used mainly as a diagnostic tool in patients with abdominal stab wounds.Patients And MethodsThirty-two hemodynamically stable patients with isolated stab wounds of the anterior abdomen, thought to be penetrating, were prospectively selected to undergo treatment via a laparoscopic approach. When possible, parenchymal wounds were coagulated or sealed, and wounds to the intestines were sutured or stapled.ResultsThe results of laparoscopy were negative in 6 (18.8%) of the cases: nonpenetrating wounds in 4 cases and nonsignificant organ injury in 2 cases. A hemoperitoneum was identified in 13 (40.6%) of the cases, and significant organ injuries in 26 (81.3%) of the cases: stomach, 2; small bowel, 5; colon, 2; pancreas, 1; vascular injuries, 4; liver, 5; mesentery, 9. Laparoscopy was therapeutic in 20 (62.3%) of the cases. Conversion to open surgery was required in 6 (18.8%) of the cases. No injuries were missed, and no mortality occurred. Postoperative complications developed in 2 (6.2%) of the cases. The mean hospital stay was 4 days, with no late complications.ConclusionsLaparoscopy can avoid a number of unnecessary laparotomies and can treat most of the lesions found in hemodynamically stable patients with anterior abdominal stab wounds.

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