Definition & Overview

A diagnostic laparoscopy is a minimally invasive medical procedure performed to examine the internal organs particularly the abdomen and pelvis. Unlike traditional surgical techniques, it only requires small incisions, thus reducing the risk of bleeding and the appearance of scars as well as shortens the recovery process that follows the procedure.

Who Should Undergo and Expected Results

When patients complain of symptoms affecting the abdominal area, such as pain, swelling, constipation, or diarrhoea, they are advised to undergo X-ray or ultrasound scans to determine the problem. However, if the results of these procedures are inconclusive, a diagnostic laparoscopy is often recommended.

The symptoms mentioned above may be signs of any abnormality involving any of the abdominal and pelvic organs. These include any of the following:

  • Injuries caused by an accident
  • Lesions
  • Benign growths
  • Cancerous tumours
  • Bleeding
  • Intestinal obstruction
  • Inflamed organs
  • Infertility
  • Hernias


The procedure plays a key role in diagnosing a wide range of diseases and medical conditions, including:

  • Appendicitis
  • Endometriosis
  • Cholecystitis
  • Ovarian cysts
  • Cancer and metastasis
  • Uterine fibroids
  • Pelvic inflammatory disease
  • Liver disease

How is the Procedure Performed?

A diagnostic laparoscopy is performed in a hospital or a fully-equipped surgical centre. It requires general anaesthesia, which means the patient is asleep and completely pain-free throughout the procedure.

The surgeon begins by making a small incision usually below the belly button where a special tube is inserted. Carbon dioxide gas is then passed through the tube to expand the organs. In some cases, the surgeon also injects dye through the tube; this is often done in the case of cervical laparoscopy wherein the fallopian tubes need to be examined.

A tiny video camera is then inserted through the tube. As it goes through the organs, it captures images of the inside of the body that the surgeon uses to look for potential problems or abnormalities.

Depending on the unique factors of each case, additional surgical instruments may be used and more small incisions made. If certain problems, such as abnormal growth, is discovered, a small tissue sample from the abdominal lining can be taken during the same procedure for a biopsy.

To end the procedure, the surgeon removes the laparoscope and all the other instruments used before the incisions are sutured closed. Bandages are then used over the treatment area for protection and patient comfort during the healing process. It is normal for the cuts to feel sore during the first few days after the procedure. However, since the incisions are very small, the pain is often minimal. Nevertheless, some patients may still require a pain reliever, which the doctor can prescribe.

A diagnostic laparoscopy is usually an outpatient procedure, which means patients do not need to stay in the hospital overnight. However, they are typically advised to arrange for a ride home for their safety.

Possible Risks and Complications

A diagnostic laparoscopy comes with a number of risks and possible complications, such as:

  • Infection
  • Organ puncture and leakage
  • Bleeding in the abdominal cavity
  • Adverse reaction to the anaesthetic used during the procedure
  • Inflamed abdominal wall
  • Blood clot


If serious complications occur during a laparoscopy, the surgeon may need to perform an emergency laparotomy, or an open surgical procedure.

Post-procedural complications may cause the following symptoms:

  • Stomach pain that gets worse over time
  • Fever
  • Chills
  • Redness
  • Swelling
  • Bleeding
  • Pus draining out from the incision site
  • Continuous vomiting
  • Persistent nausea
  • Persistent cough
  • Shortness of breath
  • Urinary retention
  • Lightheadedness


These symptoms should be reported to the doctor immediately.



References:

  • El-labban GM., Hokkam EN. “The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain.” J Minim Access Surg. 2010 Oct-Dec; 6(4): 95-99. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992668/

  • Nayak P., Mahapatra PC., Mallick JJ., et al. “Role of diagnostic hystero-laparoscopy in the evaluation of infertility: A retrospective study of 300 patients.” J Hum Reprod. Sci. 2013 Jan-Mar; 6(1): 32-34. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713574/

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