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Surgical Endoscopy

, Volume 26, Issue 8, pp 2134–2164 | Cite as

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

  • Ferdinando AgrestaEmail author
  • Luca Ansaloni
  • Gian Luca Baiocchi
  • Carlo Bergamini
  • Fabio Cesare Campanile
  • Michele Carlucci
  • Giafranco Cocorullo
  • Alessio Corradi
  • Boris Franzato
  • Massimo Lupo
  • Vincenzo Mandalà
  • Antonino Mirabella
  • Graziano Pernazza
  • Micaela Piccoli
  • Carlo Staudacher
  • Nereo Vettoretto
  • Mauro Zago
  • Emanuele Lettieri
  • Anna Levati
  • Domenico Pietrini
  • Mariano Scaglione
  • Salvatore De Masi
  • Giuseppe De Placido
  • Marsilio Francucci
  • Monica Rasi
  • Abe Fingerhut
  • Selman Uranüs
  • Silvio Garattini
Consensus Statement

Abstract

Background

In January 2010, the SICE (Italian Society of Endoscopic Surgery), under the auspices of the EAES, decided to revisit the clinical recommendations for the role of laparoscopy in abdominal emergencies in adults, with the primary intent being to update the 2006 EAES indications and supplement the existing guidelines on specific diseases.

Methods

Other Italian surgical societies were invited into the Consensus to form a panel of 12 expert surgeons. In order to get a multidisciplinary panel, other stakeholders involved in abdominal emergencies were invited along with a patient’s association. In November 2010, the panel met in Rome to discuss each chapter according to the Delphi method, producing key statements with a grade of recommendations followed by commentary to explain the rationale and the level of evidence behind the statements. Thereafter, the statements were presented to the Annual Congress of the EAES in June 2011.

Results

A thorough literature review was necessary to assess whether the recommendations issued in 2006 are still current. In many cases new studies allowed us to better clarify some issues (such as for diverticulitis, small bowel obstruction, pancreatitis, hernias, trauma), to confirm the key role of laparoscopy (such as for cholecystitis, gynecological disorders, nonspecific abdominal pain, appendicitis), but occasionally previous strong recommendations have to be challenged after review of recent research (such as for perforated peptic ulcer).

Conclusions

Every surgeon has to develop his or her own approach, taking into account the clinical situation, her/his proficiency (and the experience of the team) with the various techniques, and the specific organizational setting in which she/he is working. This guideline has been developed bearing in mind that every surgeon could use the data reported to support her/his judgment.

Keywords

Laparoscopy Acute abdomen Guidelines 

Notes

Acknowledgements

The authors thank Mrs. Janette Hanney from the UK for the linguistic review of the manuscript, and Mr. Giorgio Scaramuzza for the Cittadinanzattiva (Citizenship), and Doctor A. L. Del Favero, CEO ULSS7 della Regione Veneto, Pieve di Soligo (TV), for the Federsanità (Italian Federation of Local Health District and Municipalities), for their active presence and contribution to this Consensus. Scientific Committee of the Consensus: F. Agresta (promoter and organizer), G. L. Baiocchi, A. Corradi, E. Lettieri (Health Technology expert), M. Lupo, G. Pernazza. Experts Panel: L. Ansaloni, C. Bergamini, F. C. Campanile, M. Carlucci, G. Cocorullo, B. Franzato, V. Mandalà, A. Mirabella, M. Piccoli, C. Staudacher, N. Vettoretto, M. Zago. Representatives: M. Rasi for the IPASVI (Italian National Federation Nursing Council); S. De Masi for the ISS (Italian Health Institute); A. Levati and D. Pietrini, for the SIAARTI (Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care); Giuseppe De Placido, President of the SEGI (Italian Society of Gynecological Endoscopy) on behalf of SIGO (Italian Society of Obstetrics and Gynaecology); M. Francucci for the SIMM (Italian Hospital Managers Society); M. Scaglione for the SIRM (Italian Society of Radiology); A. L. Del Favero for the Federsanità (Italian Federation of Local Health Districts and Municipalities); G. Scaramuzza for Cittadinanzattiva (Citizenship). Reviewers: A. Fingerhut and S. Uranüs for the EAES and S. Garattini Istituto Mario Negri—Italian Cochrane Center.

Disclosures

Drs. Ferdinando Agresta, Luca Ansaloni, Gian Luca Baiocchi, Carlo Bergamini, Fabio Cesare Campanile, Michele Carlucci, Giafranco Cocorullo, Alessio Corradi, Boris Franzato, Massimo Lupo, Vincenzo Mandalà, Antonino Mirabella, Graziano Pernazza, Micaela Piccoli, Carlo Staudacher, Nereo Vettoretto, Mauro Zago, Emanuele Lettieri, Anna Levati, Domenico Pietrini, Mariano Scaglione, Salvatore De Masi, Giuseppe De Placido, Marsilio Francucci, Monica Rasi, Abe Fingerhut, Selman Uranüs, and Silvio Garattini have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ferdinando Agresta
    • 1
    Email author
  • Luca Ansaloni
    • 2
  • Gian Luca Baiocchi
    • 3
  • Carlo Bergamini
    • 4
  • Fabio Cesare Campanile
    • 5
  • Michele Carlucci
    • 6
  • Giafranco Cocorullo
    • 7
  • Alessio Corradi
    • 8
  • Boris Franzato
    • 9
  • Massimo Lupo
    • 10
  • Vincenzo Mandalà
    • 10
  • Antonino Mirabella
    • 10
  • Graziano Pernazza
    • 11
  • Micaela Piccoli
    • 12
  • Carlo Staudacher
    • 13
  • Nereo Vettoretto
    • 14
  • Mauro Zago
    • 15
  • Emanuele Lettieri
    • 16
  • Anna Levati
    • 17
  • Domenico Pietrini
    • 18
  • Mariano Scaglione
    • 19
  • Salvatore De Masi
    • 20
  • Giuseppe De Placido
    • 21
  • Marsilio Francucci
    • 22
  • Monica Rasi
    • 23
  • Abe Fingerhut
    • 24
  • Selman Uranüs
    • 25
  • Silvio Garattini
    • 26
  1. 1.Department of General SurgeryPresidio Ospedaliero di AdriaAdriaItaly
  2. 2.Department of General SurgeryOspedali RiunitiBergamoItaly
  3. 3.Department of Medical and Surgical Sciences, Surgical ClinicBrescia UniversityBresciaItaly
  4. 4.Department of General, Emergency and Mini-invasive SurgeryUniversity Hospital of CareggiFlorenceItaly
  5. 5.Department of General SurgeryOspedale di Civita CastellanaCivita CastellanaItaly
  6. 6.Department of Emergency SurgeryIRCCS San RaffaeleMilanItaly
  7. 7.Department of General, Emergency and Transplantation SurgeryA.O.U.P. Paolo GiacconePalermoItaly
  8. 8.Department of General SurgeryRegional Hospital of BolzanoBolzanoItaly
  9. 9.Department of General SurgerySan Giacomo Apostolo HospitalCastelfranco VenetoItaly
  10. 10.Department of General and Emergency Surgery“Villa Sofia—Cervello” Hospital TrustPalermoItaly
  11. 11.Department of General, Laparoscopic and Robotic SurgeryAzienda Ospedaliera San Giovanni AddolorataRomeItaly
  12. 12.Department of General SurgeryNuovo Ospedale Civile S. Agostino Estense BaggiovaraModenaItaly
  13. 13.Department of General SurgeryIRCCS San RaffaeleMilanItaly
  14. 14.Laparoscopic Surgery UnitAzienda Ospedaliera “M. Mellini”ChiariItaly
  15. 15.Minimally Invasive Surgery Unit, Department of General SurgeryPoliclinico Ponte San PietroBergamoItaly
  16. 16.Department of ManagementEconomics and Industrial EngineeringMilanItaly
  17. 17.District of Pavia HospitalPaviaItaly
  18. 18.Institute of Anesthesiology and Intensive CareCatholic University Medical SchoolRomeItaly
  19. 19.Department of Diagnostic ImagingPineta Grande Medical CenterCastel VolturnoItaly
  20. 20.Azienda Ospedaliera-Universitaria MeyerFlorenceItaly
  21. 21.Department of Gynaecology and Obstetrics“Federico II” UniversityNaplesItaly
  22. 22.Department of General SurgeryAzienda Ospedaliera “S. Maria”TerniItaly
  23. 23.Registered Nurse, Surgical Operative Theatre CoordinatorBolognaItaly
  24. 24.Surgical Unit Hippocration HospitalAthensGreece
  25. 25.Universitätsklinik für ChirurgieGrazAustria
  26. 26.Institute for Pharmacological Research“Mario Negri”MilanItaly

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