"Awake" laparoscopy for the evaluation of equivocal penetrating abdominal wounds

Jordan A. Weinberg, Louis J. Magnotti, Norma M. Edwards, Jeffrey A. Claridge, Gayle Minard, Timothy Fabian, Martin Croce

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Diagnostic laparoscopy is useful for the assessment of equivocal penetrating abdominal wounds, and has become the modality of choice for the evaluation of such wounds at our institution. We hypothesised that, in appropriate patients, diagnostic "awake" laparoscopy (AL) could be performed under local anaesthesia in the emergency department (ED), allowing for expedited discharge and potential cost savings. Methods: Selected haemodynamically stable patients with penetrating abdominal injury underwent AL. Suitability for AL was at the discretion of the attending surgeon. Identification of peritoneal penetration by AL led to exploratory laparotomy in the operating room. Patients with no evidence of peritoneal penetration were discharged from the ED (ALneg). These patients were matched to a cohort of 24 patients who underwent diagnostic laparoscopy in the OR which was negative for peritoneal penetration (DLneg). Length of stay and hospital charges were compared. Results: Over a 30-month period, 15 patients underwent AL without complication. No peritoneal penetration was found in 11 patients. The remaining four patients underwent exploratory laparotomy, of which two were positive for intra-abdominal injury. Mean time to discharge was 7 h in the ALneg group versus 18 h in the DLneg group (p = 0.0003). Cost savings on hospital charges averaged US$ 2227 per patient in the ALneg group compared with the DLneg group. Conclusions: AL may be safely performed in the ED, allowing for expedited patient discharge. Cost savings are achieved by the avoidance of charges inherent to diagnostic laparoscopy performed in the operating room.

Original languageEnglish (US)
Pages (from-to)60-64
Number of pages5
JournalInjury
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2007

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Penetrating Wounds
Laparoscopy
Cost Savings
Hospital Charges
Hospital Emergency Service
Abdominal Injuries
Operating Rooms
Laparotomy
Patient Discharge
Local Anesthesia
Length of Stay

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Cite this

Weinberg, J. A., Magnotti, L. J., Edwards, N. M., Claridge, J. A., Minard, G., Fabian, T., & Croce, M. (2007). "Awake" laparoscopy for the evaluation of equivocal penetrating abdominal wounds. Injury, 38(1), 60-64. https://doi.org/10.1016/j.injury.2006.08.061

"Awake" laparoscopy for the evaluation of equivocal penetrating abdominal wounds. / Weinberg, Jordan A.; Magnotti, Louis J.; Edwards, Norma M.; Claridge, Jeffrey A.; Minard, Gayle; Fabian, Timothy; Croce, Martin.

In: Injury, Vol. 38, No. 1, 01.01.2007, p. 60-64.

Research output: Contribution to journalArticle

Weinberg, JA, Magnotti, LJ, Edwards, NM, Claridge, JA, Minard, G, Fabian, T & Croce, M 2007, '"Awake" laparoscopy for the evaluation of equivocal penetrating abdominal wounds', Injury, vol. 38, no. 1, pp. 60-64. https://doi.org/10.1016/j.injury.2006.08.061
Weinberg JA, Magnotti LJ, Edwards NM, Claridge JA, Minard G, Fabian T et al. "Awake" laparoscopy for the evaluation of equivocal penetrating abdominal wounds. Injury. 2007 Jan 1;38(1):60-64. https://doi.org/10.1016/j.injury.2006.08.061
Weinberg, Jordan A. ; Magnotti, Louis J. ; Edwards, Norma M. ; Claridge, Jeffrey A. ; Minard, Gayle ; Fabian, Timothy ; Croce, Martin. / "Awake" laparoscopy for the evaluation of equivocal penetrating abdominal wounds. In: Injury. 2007 ; Vol. 38, No. 1. pp. 60-64.
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