Laparoscopy for the management of penetrating and blunt abdominal trauma (a systematic review)
DOI:
https://doi.org/10.14739/2310-1210.2026.1.344627Keywords:
abdominal trauma, laparoscopy, minimal invasive surgery, blunt injuries, penetration traumaAbstract
The role of diagnostic and therapeutic laparoscopy in abdominal trauma has expanded over the last decade, but indications, safety, and comparative effectiveness versus laparotomy remain debated. Recent data, including large multicentre cohorts and updated meta-analyses, justify a focused synthesis.
Aim. To systematically review contemporary evidence on the effectiveness and safety of laparoscopy for the management of penetrating and blunt abdominal trauma, including case reports published over the last five years.
Materials and methods. Following PRISMA 2020 guidance, we searched PubMed / MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar. We included prospective/retrospective clinical studies and case series evaluating laparoscopy in abdominal trauma. Primary outcomes included non-therapeutic laparotomy (NTL) rates, missed injuries, complications, conversion rates, length of stay (LOS), and mortality. Risk of bias was assessed using ROBINS-I for non-randomized studies and descriptive appraisal for case reports.
Results. The search has identified two recent systematic reviews / meta-analyses on abdominal trauma (one blunt-specific, one mixed blunt/penetrating), several cohort / propensity-matched studies (including large registry analyses), and multiple single-center series and case reports published during 2020–2025. Laparoscopy in hemodynamically stable trauma patients consistently reduced NTL (19 % absolute reduction in a large single-center series) and postoperative complications and shortened LOS compared with laparotomy, without increasing missed injuries or mortality. Multicenter registry data for blunt trauma and recent retrospective cohorts showed that laparoscopic intervention in selected patients did not increase in-hospital mortality and was associated with acceptable conversion and complication rates. Case reports and small series document successful laparoscopic management of complex injuries (diaphragmatic rupture, hollow viscus injuries, colon trauma, post-traumatic hernias) in both blunt and penetrating mechanisms, with low morbidity in carefully selected patients.
Conclusions. The accumulated evidence strongly supports the role of laparoscopy in the management of penetrating and blunt abdominal trauma in hemodynamically stable patients. The use of laparoscopy in trauma management significantly reduces the rate of non-therapeutic laparotomies and postoperative complications and shortens hospital stays. Laparoscopy for abdominal trauma maintains very low rates of missed injuries and mortality when applied with strict patient selection and surgeon expertise.
References
Yumoto T, Kosaki Y, Yamakawa Y, Iida A, Yamamoto H, Yamada T, et al. Occult Sources of Bleeding in Blunt Trauma: A Narrative Review. Acta medica Okayama. 2017;71(5):363-8. doi: https://doi.org/10.18926/AMO/5543
Lurin I, Vorovskiy O, Makarov V, Khoroshun E, Nehoduiko V, Ryzhenko A, et al. Management of thoracoabdominal gunshot injuries by using minimally invasive surgery at role 2 deployed field hospitals in Ukraine. BMC Surg. 2024;24(1):183. doi: https://doi.org/10.1186/s12893-024-02475-3
Kanlerd A, Auksornchart K, Boonyasatid P. Non-operative management for abdominal solidorgan injuries: A literature review. Chin J Traumatol. 2022;25(5):249-56. doi: https://doi.org/10.1016/j.cjtee.2021.09.006
Gulack BC, Wong K, Sparks E, Ramjist J, Zhu H, Pierro A. Is the Laparotomy Here to Stay? A Review of the Disadvantages of Laparoscopy. Eur J Pediatr Surg. 2020;30(2):181-6. doi: https://doi.org/10.1055/s-0040-1703009
Short AR. The uses of coelioscopy. BMJ. 1925;2(3371):254-5. doi: https://doi.org/10.1136/bmj.2.3371.254
Lim KH, Chung BS, Kim JY, Kim SS. Laparoscopic surgery in abdominal trauma: a single center review of a 7-year experience. World J Emerg Surg. 2015;10:16. doi: https://doi.org/10.1186/s13017-015-0007-8
Ki YJ, Jo YG, Park YC, Kang WS. The Efficacy and Safety of Laparoscopy for Blunt Abdominal Trauma: A Systematic Review and Meta-Analysis. J Clin Med. 2021;10(9):1853. doi: https://doi.org/10.3390/jcm10091853
Güsgen C, Breuing J, Prediger B, Bieler D, Schwab R. Surgical management of injuries to the abdomen in patients with multiple and/or severe trauma- a systematic review and clinical practice guideline update. Eur J Trauma Emerg Surg. 2025;51(1):177. doi: https://doi.org/10.1007/s00068-025-02841-7
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. doi: https://doi.org/10.1136/bmj.i4919
Wang J, Cheng L, Liu J, Zhang B, Wang W, Zhu W, et al. Laparoscopy vs. Laparotomy for the Management of Abdominal Trauma: A Systematic Review and Meta-Analysis. Front Surg. 2022;9:817134. doi: https://doi.org/10.3389/fsurg.2022.817134
Alalawi Y, Alharthi N, Alamrani SAS. Updates on Laparoscopy Versus Laparotomy in the Management of Penetrating Abdominal Trauma: A Systematic Review. Cureus. 2025;17(2):e79231. doi: https://doi.org/10.7759/cureus.79231
Victory J, Golden A, Jaikaran O, Vu AH, Ferzli GS. Emergent trauma surgery: a narrative review of laparoscopy, thoracoscopy and robotics. Ann Laparosc Endosc Surg. 2025;10:18. doi: https://doi.org/10.21037/ales-23-23
Jeon S, Choi KK. Single-Incision Laparoscopy in Abdominal Trauma: Current Evidence, Clinical Applications, and Evolving Role-A Narrative Review. J Clin Med. 2025;14(10):3610. doi: https://doi.org/10.3390/jcm14103610
Sermonesi G, Tian BW, Vallicelli C, Abu-Zidan FM, Damaskos D, Kelly MD, et al. Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies and abdominal trauma. World J Emerg Surg. 2023;18(1):57. doi: https://doi.org/10.1186/s13017-023-00520-9
Omoto K, Tanaka C, Kuno M, Yokobori S. Current status and safety of laparoscopic surgery for patients with blunt abdominal trauma: A multicenter study using the Japan Trauma Data Bank. Asian J Endosc Surg. 2024;17(2). doi: https://doi.org/10.1111/ases.13287
Alyami R, Alotaibi AE, Almohayya L, Jawad AA, Almukhayzim R, Alhoumedan A, et al. Role of laparoscopic surgery in blunt abdominal trauma; retrospective analysis in a tertiary trauma center. BMC Surg. 2025;25(1):8. doi: https://doi.org/10.1186/s12893-024-02744-1
Alzarouni N, Salem A, Nurelhuda NM, Osman R, Eltayyeb Y. Role of laparoscopy in patients with abdominal trauma: Rashid Hospital Trauma Center experience. J Emerg Med Trauma Acute Care. 2022;2022(5). doi: https://doi.org/10.5339/jemtac.2022.30
Kim DH, Kim M, Lee DS, Hong TH, Park H, Cho H. Role of laparoscopic surgery in managing hemodynamically stable abdominal trauma patients: a single level I trauma center, propensity score matching study. Eur J Trauma Emerg Surg. 2024;50(5):2517-25. doi: https://doi.org/10.1007/s00068-024-02642-4
Mikheiev IO, Gumeniuk KV, Tielushko YV, Mialkovskyi DS, Savchenko SI. First experience of laparoscopic colon resection with primary anastomosis for combat-related thoracoabdominal trauma with through-and-through colon injury. Modern Medical Technology. 2025;17(1):73-8. doi: https://doi.org/10.14739/mmt.2025.1.320424
Pesch CM, Janki S, Faraj D, Hueting WE. Laparoscopic repair of a traumatic diaphragmatic rupture. Int J Surg Case Rep. 2024 May;118:109644. doi: https://doi.org/10.1016/j.ijscr.2024.109644
Elgeldawy MM, Alfelakawi RF, Alabhoul F, Dokhi AH. Laparoscopic Repair of Ileal Perforation Post Blunt Abdominal Trauma: A Case Report. Asian Journal of Case Reports in Surgery. 2025;8(1):11-5. doi: https://doi.org/10.9734/ajcrs/2025/v8i1591
Abu Aagla K, Bafadni M. Laparoscopic exploration for a thoracoabdominal gunshot wound and retrieval of a wandering bullet: a case report. Int J Surg Open. 2024;62(3):222-5. doi: https://doi.org/10.1097/io9.0000000000000044
Gumeniuk K, Lurin I, Savytskyi O, Nehoduiko V, Makarov V, Smolianyk K. Surgical tactics in fire kidney injury and the first experience in performing laparoscopic nephrectomy at the II level of medical support (role II) in combat conditions: Case report. Int J Surg Case Rep. 2023;106:108046. doi: https://doi.org/10.1016/j.ijscr.2023.108046
Fu JN, Zhou L, Ma T. The role of laparoscopy in closed abdominal injury. Heliyon. 2023;9(10):e20705. doi: https://doi.org/10.1016/j.heliyon.2023.e20705
Rayan Y, Albokhary A, Maghraby A. The Outcome of laparoscopy in blunt abdominal trauma. Aswan University Medical Journal. 2024. doi: https://doi.org/10.21608/aumj.2024.263812.1101
Higuchi S, Takahashi T, Kurokawa Y, Saito T, Yamamoto K, Momose K, et al. Laparoscopic repair of a traumatic diaphragmatic hernia with repeated colon incarcerations 7 years after injury: a case report. Surg Case Rep. 2023;9(1):212. doi: https://doi.org/10.1186/s40792-023-01791-9
Marietta M, Burns B. Penetrating Abdominal Trauma. [Updated 2025 Feb 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459123/
Faulhaber L, Bockhorn M, Alfarawan F. Robot-assisted laparoscopic repair of a right-sided traumatic diaphragmatic hernia: A case report. Annals of Case Reports. 2025;10(1): 2209. doi: https://doi:10.29011/2574-7754.102209
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Iu. O. Mikheiev, I. V. Sobko, V. V. Burluka, O. O. Fomin
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 
