Diagnostic Laparoscopy

Diagnostic laparoscopy is a procedure that allows a surgeon to look directly at the contents of a patient's abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel, appendix, liver, and gallbladder.

The purpose of this examination is to actually see if a problem exists that has not been found with noninvasive tests. Inflammation of the gallbladder (cholecystitis), appendix (appendicitis), pelvic organs (pelvic inflammatory disease), or tumors of the ovaries may be diagnosed laparoscopically.

Additionally, the provider may wish to exclude abdominal trauma following an accident by using laparoscopy rather than a large abdominal incision.

Major procedures to treat cancer, such as surgery to remove an organ, may begin with laparoscopy to exclude the presence of additional tumors (metastatic disease), which would change the course of treatment.

How the test is performed

The procedure is usually done in the hospital or outpatient surgical center under general anesthesia (while the patient is unconscious and pain-free). However, this procedure may also be done using local anesthesia, which merely numbs the area affected by the surgery and allows the patient to stay awake.

A small incision is made below the naval, a needle is inserted into the incision, and carbon dioxide gas is injected to elevate the abdominal wall, creating a larger space to work in. This allows for easier viewing and manipulation of the organs. A tube called a trocar is inserted through the incision, which allows passage of a tiny video camera into the abdomen.

The laparoscope is then inserted so that the organs of the pelvic and abdomen can be examined. Additional small incisions may be made for instruments that allow the surgeon to move organs for a clearer view.

Following the examination, the laparoscope is removed, the incisions are closed, and the bandages are applied.