Laparoscopic procedures use a long, slender tube with a light and camera on the tip. This is inserted through a small incision, which then displays the internal images on an external monitor. Laparoscopic procedures can be surgical in nature, allowing for hysterectomies (removal of the uterus) and partial colectomies (removing part of the colon) with minimal scarring and less chance of infection. However, diagnostic laparoscopy can be equally helpful, especially when other imaging technology, such as an ultrasound, is not as effective as necessary. It can not only be used for viewing, but for assessing damage and performing more specific diagnostic procedures.
Assessment
Nearly any abdominal organ can be examined laparoscopically. Exploratory laparotomies were originally used for this, essentially requiring open surgery to get a diagnostic peek when not enough information was available. Laparotomies require a large incision in the abdomen, followed by examining the organs or areas in question. Laparoscopy allows the same attention to detail with a smaller incision, which heals more quickly.
According to the National Institute of Health, the following organs are the often assessed in this way:
- Appendix
- Bladder
- Gallbladder
- Intestines
- Kidney and ureters
- Liver
- Pancreas
- Spleen
- Stomach
- Uterus, fallopian tubes, and ovaries
Diagnosis
There are several reasons for this examination. When liver disease is present, doctors can determine how progressed the damage is. Laparoscopies can also find gallbladder stones, excessive abdominal fluid, and help diagnose extreme abdominal pain. When large masses are present in the abdomen, a biopsy can be performed at the same time. A small amount of tissue is removed and sent to a pathologist to find abnormalities.
Additionally, laparoscopic procedures can be used to determine if cancer is spreading and how effective treatment is. In some cases, the treatment can be performed at the same time as the diagnosis. For example, in women with endometriosis, a laparoscopic procedure can be used to determine the presence of the tissue as well as remove it.