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Diagnostic laparoscopy

Diagnostic laparoscopy is a procedure that allows a doctor to look directly at the contents of a patient's abdomen or pelvis.

Alternative Names

Laparoscopy - diagnostic; Exploratory laparoscopy

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). The procedure is performed in the following way:

  • The surgeon makes a small cut (incision) below the belly button (navel).
  • A needle or tube is inserted into the incision. Carbon dioxide gas is passed into the abdomen through the needle or tube. The gas helps expand the area, giving the surgeon more room to work, and helping 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 view 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 may need to stop taking medications, including narcotic pain relievers, on or before the day of the exam. Do not change or stop taking any medications without first talking to your health care provider.

Follow any other instructions for how to prepare for the procedure.

How the Test will Feel

You will feel no pain during the procedure.

Afterward, the incisions may be sore. 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 a 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 have had a past surgery.

References

Fried GM. Emerging technology in surgery: informatics, robotics, and electronics. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 17.

Mishra RK. Textbook of Practical Laparoscopic Surgery. New Delhi, India: Jaypee Brothers Medical Publishers; 2013.

Updated: 7/30/2014

John A. Daller, MD, PhD, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR. Review Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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