Ahmed et al used laparoscopy to evaluate patients with possible penetrating wounds to the abdomen. This can be safe and effective provided a careful protocol is followed. Its use can reduce health care costs and is associated with earlier patient discharges.


Criteria to select a patient for diagnostic abdominal laparoscopy - all of the following:

(1) stab and/or gunshot wounds to abdomen, including the junction zone (entry point below the nipple), with possible infradiaphragmatic penetration

(2) stable vital signs

(3) intact sensorium without evidence of raised intracranial pressure

(4) ability to give informed consent

(5) no contraindications for pneumoperitoneum (due to risk for gas embolism)

(6) negative CT scan of the abdomen


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