| Subject | Contents |
| Definition | Diagnostic laparoscopy is a procedure that allows the health care provider to look directly at the contents of the abdomen and pelvis, including the fallopian tubes, ovaries, uterus, small bowel, appendix, liver, and gallbladder.
The purpose of this examination is to directly assess the presence of pathology: for example inflammation of the gallbladder (cholecystitis), appendix (appendicitis), and pelvic organs (Pelvic Inflammatory Disease). Additionally, the health care provider may wish to exclude abdominal trauma by laparoscopy rather than a large abdominal incision (laparotomy). Finally, large operations, such as liver and pancreatic resections, may begin with laparoscopy to exclude the presence of additional tumors (metastatic disease) that would preclude curative resection. |
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| How the test is performed | The procedure is usually done in the hospital under general anesthesia, (however it may be done under local anesthesia), after informed consent has been obtained. A catheter (a small flexible tube) is inserted through the urethra into the bladder. The skin of the abdomen is cleansed, and sterile drapes are applied. A small incision is made above or below the navel to allow the insertion of a trocar (essentially a tube extending from inside the abdomen to the outside) that allows passage of a video camera. Prior to insertion of the trocar, a needle is inserted into the incision and carbon dioxide gas is injected to elevate the abdominal wall, and thereby create a larger space to work in. This allows for easier viewing and manipulation of the organs. After an adequate amount of gas is instilled, the laparoscope is inserted, and the organs of the pelvis and abdomen are examined. Occasionally, additional small incisions are made for instruments that enable the surgeon to move the abdominal and pelvic organs for complete visualization. These incisions are far smaller than the one-inch incision at the navel. In the case of gynecologic laparoscopy, dye may be injected through the cervical canal to make the fallopian tubes easier to view. Following the examination, the laparoscope is then removed, the incision is closed with sutures, and bandages are applied. The smaller incisions are merely closed with band-aids. |
| How to prepare for the test | You cannot have any food or fluid for 8 hours before the test. You must sign a consent form. Infants and children: The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:Infant test or procedure preparation (birth to 1 year) Toddler test or procedure preparation (1 to 3 years) Preschooler test or procedure preparation (3 to 6 years) Schoolage test or procedure preparation (6 to 12 years) Adolescent test or procedure preparation (12 to 18 years) |
| How the test will feel | Under general anesthesia, no pain will be felt during the procedure, however the incision site may throb and be slightly painful afterward. A pain reliever may be given by your physician.
With local anesthesia, you may feel a prick and a burning sensation when the local anesthetic is given. Pain may occur at the incision site. The laparoscope may cause pressure, but there should be no pain during the procedure. Afterward, the incision site may throb for several hours and be slightly painful. A pain reliever may be given by your physician. Additionally, you may experience shoulder pain for a few days, since the gas can irritate the diaphragm, which shares some of the same nerves as the shoulder. Finally, you may experience an increased urge to urinate since the gas can put pressure on the bladder. |
| Why the test is performed | The examination helps identify the cause of pain in the abdomen and pelvic area. It may detect endometriosis (tissues normally found in the uterus growing in other areas), an ectopic pregnancy (in which the fertilized egg develops outside of the uterus), pelvic inflammatory disease (an inflammation in the pelvic cavity), cancer , or other problems including inflammation of the gallbladder or appendix. See section on intra-abdominal laparoscopy . |
| Normal Values | The uterus, fallopian tubes, and ovaries are of normal size, shape, and color, and the liver is normal. There is no blood in the abdomen, no hernias, no intestinal obstruction, or no cancer in any visible organs.
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| What abnormal results mean | The procedure may detect ovarian cysts or ovarian tumors (abnormal growth or sac containing a fluid, gas, or semisolid material), an abnormal union of body surfaces, endometriosis , uterine fibroids (a noncancerous tumor ), tumors, pelvic inflammatory disease , appendicitis, cholecystitis, metastatic cancer, or signs of trauma. |
| What the risks are | There is a risk of puncturing an organ, which could cause leakage of intestinal contents, or bleeding into the abdominal cavity. These complications often result in the conversion of laparoscopy to laparotomy. There is also some risk of infection; however, antibiotics are usually given as a precaution. |
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