What is diagnostic laparoscopy?
Diagnostic laparoscopy involves the insertion of a thin camera-tipped instrument called a laparoscope through a small incision to examine a patient's abdomen or pelvis. This includes the fallopian tubes, ovaries, uterus, small and large bowels, appendix, liver and gallbladder. A diagnostic laparoscopy is typically done to confirm the presence or absence of a condition when noninvasive tests, such as X-ray or ultrasound, prove inconclusive, and to help the surgeon determine the proper course of treatment. There are situations in which a diagnostic laparoscopy may be contraindicated, as, for example, when the patient has a swollen bowel, fluid in the abdomen, or another serious medical condition.
When is diagnostic laparoscopy necessary?
There are many reasons diagnostic laparoscopy may be performed. This procedure helps identify the cause of pain or a growth in the abdomen or pelvic area and may also be done instead of open surgery after an accident or before surgery. Reasons for laparoscopy include investigation of the area for:
- Ovarian cysts
- Uterine fibroids
- Pelvic inflammatory disease
- Metastatic cancer
- Signs of trauma
What are the benefits of a diagnostic laparoscopy?
There are many benefits to a diagnostic laparoscopy, including the following:
More accurate diagnosis - This minimally invasive procedure may help the doctor to make a more accurate assessment of disease, injury, inflammation, abnormal growths, or infertility.
Small incision - Diagnostic laparoscopy requires only a very small incision that closes without surgical stitches and results in less post-surgical pain and no noticeable scarring.
Treatment options - The doctor may be able to treat, as well as detect, the cause of the problem during the procedure.
Shorter recovery time - The patient's stay at the hospital and the time needed for recovery are much shorter than with more invasive surgery.
Fewer complications - Laparoscopy is a safe, efficient procedure, resulting in many fewer complications than open surgery.
How is diagnostic laparoscopy performed?
The procedure may be done in a hospital or surgical center, under local or general anesthesia. First, carbon dioxide gas is injected through a needle to create a work space. Next, a tube called is inserted into which the laparoscope is introduced. If the surgeon requires the use of additional surgical instruments, other small incisions may be made.
Will there be pain or discomfort after diagnostic laparoscopy?
There may be throbbing or sensitivity at the incision site for a few hours following surgery. Shoulder pain is also possible, because the injected carbon dioxide may irritate nerves in the diaphragm that also run through the shoulder. An increased urge to urinate may be caused by carbon-dioxide gas pressure on the bladder. The patient may experience cramping or bloating, but all discomfort is usually gone in one to two days.
What are the risks of diagnostic laparoscopy?
There are some risks associated with any surgical procedure, however minor. These may include excessive bleeding, adverse reactions to anesthesia or medications, or breathing difficulty. Possible complications of a diagnostic laparoscopy include:
Infection - In order to avoid the risk of infection, some physicians may prescribe antibiotics prophylactically.
Organ puncture - While rare, an organ may be nicked during the procedure in which case intestinal leakage and/or bleeding may occur. This may precipitate the need for immediate open surgery.
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