Six-year experience of laparoscopic decompression of the abdominal trunk

Introduction. The choice of optimal surgical access in the treatment of abdominal trunk compression syndrome remains a subject of discussion to date. Traditional laparotomy in the era of minimally invasive surgical technologies seems to be excessively traumatic, while laparoscopic interventions are associated with a high risk of complications that are difficult to eliminate with this access, primarily bleeding.

The objective was to analyze the six-year experience of laparoscopic decompression of the abdominal trunk on the basis of the Scientific Research Institute of Surgery and Emergency Medicine of the Pavlov University.

Metods and materials. In the period from November 2018 to July 2024, 27 laparoscopic abdominal trunk decompression procedures were performed at the clinic of the Research Institute of Surgery and Emergency Medicine of the Pavlov University. To prevent massive blood loss in case of injury to the abdominal artery during its laparoscopic decompression, a method for preventive installation of an endovascular balloon catheter into the abdominal trunk before performing the main stage of surgery was proposed.

Results. Two cases (7.4 %) out of 27 were complicated by the development of intraoperative bleeding due to injury to the abdominal trunk or its branches. In one case (3.7 %), laparotomy was performed. In the second case (3.7 %), the bleeding was stopped laparoscopically using the technique of preventive installation of a balloon catheter into the abdominal trunk. The volume of blood loss was 2,100 and 300 ml, respectively. Technical success was achieved in 96 % of patients. During the follow–up period of 6 months or more, good results were found in 84.6 % of patients, satisfactory – in 15.4 %. The average operation time was 85 minutes (85.15±32.45); the average postoperative bedday was 3.8 days (from 3 to 5 days).

Conclusion. Laparoscopic decompression of the abdominal trunk is an effective and sufficiently safe technique in the surgical treatment of abdominal trunk compression syndrome.

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