Diagnostic laparoscopy: Selective therapeutic approach in abdominal surgery

Abstract

Diagnostic laparoscopy (DL) has become an established method to improve decision-making in abdominal surgery. In order to evaluate the diagnostic and therapeutic value of DL, we investigated 50 cases. The main indications for DL included acute, subacute or chronic abdominal pain (46%), unknown extension of malignancies in the abdominal cavity (18%), evaluation for liver transplantation (14%) and post-operative peritonitis (10%). In 90% of cases, DL revealed the correct diagnosis. A total of 29 laparotomies were prevented by DL, either because findings were normal, an immediate operative therapy was unnecessary, or immediate laparoscopic intervention. There was no operative or post-operative morbidity following DL and patients were discharged home after a mean of 4.4 days. The main advantage of DL is that the problem can be solved by laparoscopic means rather than by diagnostic laparotomy.