Laparoscopic surgery has become a routine part in general surgery. In the emergency setting, laparoscopic surgery in appendectomy and cholecystectomy is gold standard in this modern era. However, the benefits and role of laparoscopic surgery in other areas of acute abdominal surgery remains unclear. The aim of this thesis is to investigate the role of laparoscopic surgery for emergency surgery and compare the benefits and risks of laparoscopic surgery with the current gold standard of surgical techniques with a focus on three specific areas of surgery - peptic ulcer perforation, complicated appendectomy and adhesiolysis in small bowel obstruction.
Systemic reviews for each topic were done according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases (Medline, PubMed, Cochrane Database, World Wide Web Internet and Embase) and references in the relevant articles were checked for appropriate studies.«/p» «p» «/p» «p»Meta-analyses of all three areas with a combination of 45,986 patient showed significant advantage in laparoscopic group compared with open technique. There was reduced post-operative morbidity and mortality, shorter length of hospital stays and reduced usage of post-operative analgesia in the laparoscopic group. Furthermore, there were no differences in length of operating time, post-operative intra-abdominal abscess and septicaemia.
In conclusion, this thesis has proven that laparoscopic surgery is safe and superior to open technique in treatment of perforated peptic ulcer, complicated appendicitis and adhesional small bowel in selected groups of patients.