Abstract
Emergency abdominal surgery is one of the most rapidly evolving fields of medicine, marked by the active adoption of minimally invasive technologies. Yet the strength of evidence supporting their use across different conditions remains uneven – necessitating systematisation and critical reappraisal of accumulated data, with attention to publications from 2000 to 2025. The aim was to systematise and critically evaluate the evidence from 2000 to 2025 concerning the use of minimally invasive technologies in the most common urgent abdominal conditions, and to identify promising directions for further research. A systematic literature search was conducted in the PubMed, Cochrane Library, Scopus and Web of Science databases for the period 2000-2025. Inclusion criteria covered systematic reviews, meta-analyses and randomised controlled trials. Forty-four sources were included in the analysis. For acute cholecystitis, meta-analyses demonstrated the advantages of early cholecystectomy, reducing hospital stay from 17.8 to 9.6 days with comparable mortality rates. Robot-assisted cholecystectomy reduces the conversion risk by 34% compared with conventional laparoscopy. Ultrasonic dissection shortens operating time by 9 minutes and reduces blood loss by 28 mL. For perforated ulcers, endoscopic techniques reduce respiratory complications by a factor of 2.4, though the methodological quality of the studies remains insufficient. In acute pancreatitis, an endoscopic step-up approach using lumen-apposing metal stents shows the best clinical outcomes. For adhesive small bowel obstruction, five-year follow-up studies found no long-term advantage for laparoscopy. For acute appendicitis, laparoscopic access reduces wound complications by a factor of 2.4, with comparable rates of intra-abdominal abscesses. These findings can help optimise surgical strategy in urgent abdominal conditions, informed by current evidence
Keywords
minimally invasive procedures; laparoscopy; robotic surgery; evidence-based medicine; meta-analysisSuggested citation
References
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