Laparoscopy for combat-related abdominal trauma: a single center experience during the Ukrainian War of Independence

I. A. Lurin; K. V. Gumeniuk; Iu. O. Mikheiev; R. M. Kuziv; Ya. V. Tielushko; I. V. Rusanov; D. S. Mialkovskyi; S. M. Machuskyi

doi:10.14739/2310-1210.2025.5.338404

Authors

I. A. Lurin National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0001-6280-1725
K. V. Gumeniuk Command of the Medical Forces of the Armed Forces, Ukraine https://orcid.org/0000-0001-8892-4061
Iu. O. Mikheiev Zaporizhzhia State Medical and Pharmaceutical University, Ukraine https://orcid.org/0000-0002-0305-1570
R. M. Kuziv Zaporizhzhia Military Hospital, Ukraine https://orcid.org/0009-0001-4462-9922
Ya. V. Tielushko Zaporizhzhia State Medical and Pharmaceutical University, Ukraine https://orcid.org/0000-0002-0745-6698
I. V. Rusanov Zaporizhzhia State Medical and Pharmaceutical University, Ukraine https://orcid.org/0000-0002-4363-1158
D. S. Mialkovskyi Zaporizhzhia Military Hospital, Ukraine https://orcid.org/0000-0001-5565-0850
S. M. Machuskyi Zaporizhzhia Military Hospital, Ukraine https://orcid.org/0000-0002-0985-223X

DOI:

https://doi.org/10.14739/2310-1210.2025.5.338404

Keywords:

лапароскопія, абдомінальна травма, бойові поранені, гемодинамічно стабільні пацієнти, військова медицина

Abstract

Aim. To evaluate the feasibility, indications, and outcomes of laparoscopic surgery in hemodynamically stable combat casualties with abdominal trauma during the Ukrainian War of Independence.

Material and methods. A retrospective observational study included 238 hemodynamically stable patients with combat-related abdominal trauma treated at the Zaporizhzhia Military Hospital between 2022 and 2025. Medical records, operative protocols, imaging examinations (e-FAST, computed tomography), and intraoperative documentation were analyzed.

Results. Laparoscopic procedures performed included diagnostic laparoscopy (n = 78), foreign body removal (n = 60), hemostasis (n = 23), diaphragmatic repair (n = 19), hollow viscus suturing (n = 15), splenectomy (n = 5), and colectomy / colostomy (n = 12). Conversion to laparotomy was required in 28 cases (11.8 %), while secondary laparotomy was needed in 5 patients due to missed bowel injuries, intra-abdominal abscess, ileus, or bleeding. The best outcomes were achieved in American Association for the Surgery of Trauma (AAST) grade I–II injuries. Advanced bowel resections were technically complex requiring further validation for routine use. Barbed suture-based closure improved safety and efficiency in diaphragmatic and hollow viscus repair.

Conclusions. Laparoscopy appears to be a safe and effective option for selected hemodynamically stable patients with abdominal combat trauma. It reduces rates of unnecessary laparotomies, postoperative complications, and recovery time, facilitating faster return of soldiers to duty. Complex bowel resections require further validation before routine implementation in military trauma surgery.

Author Biographies

I. A. Lurin, National Academy of Medical Sciences of Ukraine, Kyiv

MD, PhD, DSc; State Institution of Science “Center of Innovative Healthcare Technologies” State Administrative Department, Kyiv

K. V. Gumeniuk, Command of the Medical Forces of the Armed Forces

MD, PhD, Associate Professor, Colonel of the Medical Service, Chief Surgeon of the Armed Forces of Ukraine

Iu. O. Mikheiev, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, DSc, Associate Professor, Professor of the Department of Disaster Medicine and Military Medicine; Major of the Medical Service, Leading Surgeon, Zaporizhzhia Military Hospital, Military Unit A3309

R. M. Kuziv, Zaporizhzhia Military Hospital

MD, Commander of Zaporizhzhia Military Hospital

Ya. V. Tielushko, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, Associate Professor of the Department of Disaster Medicine and Military Medicine; Head of the Department of Thoracic Surgery, Zaporizhzhia Military Hospital

I. V. Rusanov, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, Associate Professor of the Department of Hospital Surgery; Head of the Department of Vascular Surgery, Zaporizhzhia Military Hospital

D. S. Mialkovskyi, Zaporizhzhia Military Hospital

MD, PhD, Senior Vascular Surgeon

S. M. Machuskyi, Zaporizhzhia Military Hospital

MD, Vascular Surgeon

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