Bedside Laparoscopy in the Critically Ill: A Review of the Literature

TL;DR

Bedside laparoscopy is a safe and effective diagnostic tool for critically ill ICU patients when other methods fail.

Contribution

This paper reviews the current literature to establish bedside laparoscopy as a preferred alternative to exploratory surgery in ICU patients.

Findings

Bedside laparoscopy is safe, feasible, and effective in ICU patients.

It avoids unnecessary exploratory laparotomy and risks of intra-hospital transfer.

BSL is preferable when other diagnostic tools fail to identify abdominal conditions.

Abstract

Critically ill patients treated in the intensive care unit (ICU) can present with many abdominal conditions that need a prompt diagnosis and timely treatment because of their general frailty. Clinical evaluation and diagnostic tools like ultrasound or CT scans are not reliable or feasible in these patients. Bedside laparoscopy (BSL) is a minimally invasive procedure that allows surgeons to assess the abdominal cavity directly in the ICU, thus avoiding unnecessary exploratory laparotomy or incidents related to intra-hospital transfer. We conducted a review of the literature to summarize the state-of-the-art of BSL. The Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases were utilized to identify all relevant publications. Indications, contraindications, technical aspects, and outcomes are discussed. The procedure is safe, feasible, and effective. When other diagnostic tools fail to diagnose or exclude an intra-abdominal condition in ICU patients, BSL should be preferred over exploratory laparotomy.