LAPAROSCOPY FOR MANAGEMENT OF GUNSHOT INJURIES IN COMBAT PATIENTS AT THE LEVEL OF ROLE 2 DEPLOYED FIELD HOSPITAL IN ONGOING WAR IN UKRAINE andrii.dinets@gmail.com

PW05-12

LAPAROSCOPY FOR MANAGEMENT OF GUNSHOT INJURIES IN COMBAT PATIENTS AT THE LEVEL OF ROLE 2 DEPLOYED FIELD HOSPITAL IN ONGOING WAR IN UKRAINE

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Ukraine

Oral only

Minimally invasive surgery is not routinely applied in combat settings at Role 2 hospital because of close location to the battlefield line (20-40 km). In the ongoing war in Ukraine, there is no aeromedical evacuation due to FPV drones and artillery strikes against sanitary transport, and differential approaches for medical provision must be considered. The aim of this study was to demonstrate and evaluate the utility of minimally invasive surgery at the Role 2 deployed hospital in East Ukraine.

There were identified 2712 patients who had ballistic injuries to the abdomen between March 2023 and May 2025 at Role 2 deployed field hospital in East Ukraine. Damage control surgery was applied to all patients.

Laparotomy was performed in 2004 (73.9%) patients and laparoscopy in 708 (26.1%) patients. Conversions were performed in 224 (31.6%) patients. Ballistic fragments were removed laparoscopically in 523 (73.8%) patients and in 1714 (85.5%) patients at laparotomy (p<0.0001). Lethal outcomes were in 34 (4.8%) patients after laparoscopy and in 132 (6.5%) patients after laparotomy (p>0.05) due to peritonitis, bleeding, and acute ulcers.

Minimally invasive surgery might be performed in selected patients in the Role 2 deployed field hospitals in case of tactical problems of medical evacuation. Our experience is suggested for adoption by military medical departments of other countries.