Patients may be referred to our surgeons because of an undiagnosed abdominal problem. This article will:

• help you understand what laparoscopy is,
• describe how laparoscopy helps to find out what the problem is,
• explain what complications can occur with the procedure.

WHAT IS DIAGNOSTIC LAPAROSCOPY?

A laparoscope is a telescope designed for medical use. It is connected to a high intensity light and a high-resolution television camera so that the surgeon can see what is happening inside of you. The laparoscope enters the abdominal cavity through a hollow tube and the image of the inside of your abdomen is seen on a monitor. 

WHY IS DIAGNOSTIC LAPAROSCOPY PERFORMED?

Abdominal pain: Laparoscopy has a role in the diagnosis of both acute and chronic abdominal pain. There are many causes of abdominal pain. Some causes include appendicitis; adhesions or intra-abdominal scar tissue; pelvic infections; endometriosis; abdominal bleeding; and less frequently, cancer. It is often used in patients with irritable bowel disease to rule out other causes of abdominal pain. Our surgeons can often diagnose the cause of the abdominal pain and, during the same procedure, correct the problem.

Abdominal mass: A patient may have a lump (mass or tumor), which can be felt by the doctor, you, or seen on an X-ray. Most masses require a definitive diagnosis before appropriate therapy or treatment can be recommended. Laparoscopy is one of the techniques available to look directly at a mass and obtain tissue to help the diagnosis.

Ascites: The presence of fluid in the abdominal cavity is called ascites. Sometimes the cause of this fluid accumulation cannot be found without looking into the abdominal cavity, which can often be accomplished with laparoscopy.

Liver disease: Non-invasive X-ray imaging techniques (sonogram, CT scan and MRI) may discover a mass inside or on the surface of the liver. If the non-invasive X-ray cannot give your physician enough information, a liver biopsy may be needed to establish the diagnosis. Diagnostic laparoscopy is one of the safest and most accurate ways to obtain tissue for diagnosis. It is an accurate way to collect a biopsy to sample the liver or mass without actually opening the abdomen.

“Second look” procedure or cancer staging: Your doctor may need information regarding the status of a previously treated disease, such as cancer. This may occur after treatment with some forms of chemotherapy or before more chemotherapy is started. Also, information may be provided by diagnostic laparoscopy before planning a formal exploration of the abdomen, chemotherapy or radiation therapy.

Other reasons: There are other reasons to undergo a diagnostic laparoscopy, which cannot all be listed here. This should be reviewed and discussed with one of our surgeons.

WHAT TESTS ARE NECESSARY BEFORE LAPAROSCOPY?

Ultrasound may be ordered by your doctor as a non-invasive diagnostic test. In many cases, information is provided which will allow us to have a better understanding of the problem inside your abdomen. This test is not painful, is very safe, and can improve the effectiveness of the diagnostic laparoscopy.

CT Scan is an X-ray that uses computers to visualize the intra-abdominal contents. In certain circumstances, it is accurate in making the diagnosis of abdominal disease. It will allow us to have a “road map” of the inside of your abdomen. A radiologist may use a CT scan to place a needle inside your abdomen. This is known as a CT guided needle biopsy. This will often be done before a diagnostic laparoscopy to decide if laparoscopy is appropriate for your condition.

MRI (magnetic resonance imaging) uses magnets, X-rays, and computers to view the inside of the abdominal cavity. It is not required for most abdominal problems, but may be necessary for some.

Routine blood test analysis, urinalysis, and possible chest X-ray or electrocardiogram may be needed before diagnostic laparoscopy. Your physician will decide which tests are necessary and will review the results of those tests, which have already been performed.

WHAT TYPE OF ANESTHESIA IS USED?

Diagnostic laparoscopy is usually performed under general anesthesia. In select cases, a regional anesthesia such as spinal or epidural anesthesia can occasionally be used.