Trauma Laparoscopy from 1925-2017: Publication History and Study Demographics of an Evolving Modality

The use of laparoscopy in trauma surgery remains a debated topic, despite having been discussed in the literature for decades. The publication history of trauma laparoscopy was reviewed to identify trends, analyze study demographics, and summarize key papers, with hopes to better inform future areas of research. A systematic search of PubMed and Cochrane libraries was performed for English-language literature involving trauma laparoscopy through August 2017. Year published, number of subjects, study design, mechanism, type of laparoscopy (screening, therapeutic, diagnostic), journal, and location of study were recorded. Ten landmark papers were then chosen for discussion based upon high level of evidence and influence upon other work. In total, 281 articles on trauma laparoscopy, encompassing 11,816 subjects, have been published. Over three-quarters of the studies were case series or case reports (76.5%). Other types of studies included: 40 reviews (14.2%), 19 editorials (6.8%), 2 case-control studies (0.7%), 2 meta-analyses (0.7%), 2 randomized controlled trials (0.7%), and 1 systematic review (0.4%). Mechanism was blunt in 92 studies (32.7%), penetrating in 100 (35.5%), and 84 studies included both mechanisms (29.9%). All types of laparoscopy were discussed in the literature, with increasing representation of therapeutic laparoscopy in recent decade. The primary journals involved included Journal of Trauma and Surgical Endoscopy. Trauma laparoscopy has become a regular tool in the armamentarium of the trauma surgeon for the evaluation and treatment of hemodynamically stable patients, regardless of mechanism of injury. There has been near exponential growth in related research over the past three decades. The type of laparoscopy performed has evolved from a screening tool into a diagnostic and therapeutic modality. Despite the large number of publications and positive outcomes, there is still a lack of high level evidence in this field, and adequately powered studies are needed to further support this approach. Correspondence: Nova Szoka, MD, Assistant Professor, West Virginia University, One Medical Center Drive, PO Box 9238, Morgantown, WV 26506-9238, Phone 304-293-1728, Fax 304-293-6628. Nova.szoka@hsc.wvu.edu Conflict of interest statement: No conflicts are declared for all authors. Abstract presented at 2016 Society of American Gastrointestinal and Endoscopic Surgeons Annual Meeting, March 16-19, 2016 in Boston, Massachusetts. No funding received from NIH, Wellcome Trust, or HHMI. © 2017 Lippincott Williams & Wilkins, Inc.

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