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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2016; 22(9): 2701-2710
Published online Mar 7, 2016. doi: 10.3748/wjg.v22.i9.2701
Laparoscopic approach in gastrointestinal emergencies
Rosa M Jimenez Rodriguez, Juan José Segura-Sampedro, Mercedes Flores-Cortés, Francisco López-Bernal, Cristobalina Martín, Verónica Pino Diaz, Felipe Pareja Ciuro, Javier Padillo Ruiz
Rosa M Jimenez Rodriguez, Mercedes Flores-Cortés, Francisco López-Bernal, Cristobalina Martín, Verónica Pino Diaz, Felipe Pareja Ciuro, Javier Padillo Ruiz, Department of Surgery, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
Juan José Segura-Sampedro, Hospital Universitario Son Espases, 07010 Palma de Mallorca, Spain
Author contributions: All authors were responsible for conceptualizing and designing the study; collecting, analysing and interpreting the data and drafting the manuscript; all authors gave their approval on the final version for publication.
Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rosa M Jimenez-Rodriguez, MD, PhD, EBSQ-c, Colorectal Unit, Department of Surgery, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain. ros_j_r@hotmail.com
Telephone: +34-606-296081 Fax: +34-955-012313
Received: October 4, 2015
Peer-review started: October 5, 2015
First decision: November 27, 2015
Revised: December 24, 2015
Accepted: January 11, 2016
Article in press: January 11, 2016
Published online: March 7, 2016
Abstract

This review focuses on the laparoscopic approach to gastrointestinal emergencies and its more recent indications. Laparoscopic surgery has a specific place in elective procedures, but that does not apply in emergency situations. In specific emergencies, there is a huge range of indications and different techniques to apply, and not all of them are equally settle. We consider that the most controversial points in minimally invasive procedures are indications in emergency situations due to technical difficulties. Some pathologies, such as oesophageal emergencies, obstruction due to colon cancer, abdominal hernias or incarcerated postsurgical hernias, are nearly always resolved by conventional surgery, that is, an open approach due to limited intraabdominal cavity space or due to the vulnerability of the bowel. These technical problems have been solved in many diseases, such as for perforated peptic ulcer or acute appendectomy for which a laparoscopic approach has become a well-known and globally supported procedure. On the other hand, endoscopic procedures have acquired further indications, relegating surgical solutions to a second place; this happens in cholangitis or pancreatic abscess drainage. This endoluminal approach avoids the need for laparoscopic development in these diseases. Nevertheless, new instruments and new technologies could extend the laparoscopic approach to a broader array of potentials procedures. There remains, however, a long way to go.

Keywords: Minimally invasive surgery, Gastrointestinal surgery, Emergency surgery, Digestive emergencies, Abdominal emergencies

Core tip: Laparoscopic surgery represents a technological revolution in the management of gastrointestinal conditions. However, the use of this minimally invasive technique has not yet been extended to emergency situations. The most likely reason is the long learning curve and the even longer operative time of emergency laparoscopy compared to elective laparoscopy.