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Diagnostic laparoscopy
Definition
Diagnostic laparoscopy is a procedure that allows a health care provider to look directly at the contents of a patient's abdomen or pelvis.
Alternative Names
Laparoscopy - diagnostic
How the Test is Performed
The procedure is usually done in the hospital or outpatient surgical center under general anesthesia (while you are asleep and pain-free). However, very rarely, this procedure may also be done using local anesthesia. This numbs only the area affected by the surgery and allows you to stay awake.
A surgeon makes a small cut below the belly button (navel) and inserts a needle into the area. Carbon dioxide gas is passed into the abdomen to expand the area. This gives the surgeon more room to work, and helps the surgeon see the organs more clearly.
A tube is placed through the cut in your abdomen. A tiny video camera (laparoscope) goes through this tube and is used to see the inside of your pelvis and abdomen. More small cuts may be made if other instruments are needed to get a better view of certain organs.
If you are having gynecologic laparoscopy, dye may be injected into your cervix area so the surgeon can better see your fallopian tubes.
After the exam, the gas, laparoscope, and instruments are removed, and the cuts are closed. You will have bandages over those areas.
How to Prepare for the Test
Do not eat or drink anything for 8 hours before the test. You must sign a consent form.
How the Test Will Feel
If you are given general anesthesia, you will feel no pain during the procedure. The surgical cuts may throb and be slightly painful afterward. Your doctor may prescribe medicine to relieve pain.
With local anesthesia, you may feel a prick and burning sensation when the local anesthetic is given. The laparoscope may cause pressure, but there should be no pain during the procedure.
Afterward, you may also feel soreness at the site of the surgical cut. Your doctor may prescribe a pain reliever.
You may also have shoulder pain for a few days. The gas used during the procedure can irritate the diaphragm, which shares some of the same nerves as the shoulder. You may also have an increased urge to urinate, since the gas can put pressure on the bladder.
You will recover for a few hours at the hospital before going home. You will probably not stay overnight after a laparoscopy.
You will not be allowed to drive home. Someone should be available to pick you up after the procedure.
Why the Test is Performed
Diagnostic laparoscopy helps identify the cause of pain or a growth in the abdomen and pelvic area. It is done if x-rays or ultrasound results are unclear.
The procedure may also be done instead of open surgery after an accident to see if there is any injury to the abdomen.
Laparoscopy may be done before procedures to treat cancer (such as surgery to remove an organ), to find out whether the cancer has spread. If it has spread, treatment will change.
Normal Results
There is no blood in the abdomen, no hernias, no intestinal obstruction, and no cancer in any visible organs. The uterus, fallopian tubes, and ovaries are of normal size, shape, and color. The liver is normal.
What Abnormal Results Mean
Abnormal results may be due to a number of different conditions, including:
- Adhesions
- Appendicitis
- Endometriosis
- Inflammation of the gallbladder (cholecystitis)
- Ovarian cysts or cancer of the ovary
- Pelvic inflammatory disease
- Signs of injury
- Spread of cancer
- Tumors
- Uterine fibroids
Risks
There is some risk of infection. You may get antibiotics to prevent this complication.
There is a risk of puncturing an organ, which could cause the contents of the intestines to leak. There may also be bleeding into the abdominal cavity. These complications could lead to immediate open surgery (laparotomy).
Diagnostic laparoscopy may not be possible if you have a swollen bowel, fluid in the abdomen (ascites), or you've had a past surgery.
References
Maa J, Kirkwood KS. The appendix. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 51.
Postier RG, Squires RA. The acute abdomen. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 47.
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review Provided by VeriMed Healthcare Network.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
