Diagnostic Laparoscopy

 

 Buy Article Permissions and Reprints

Each diagnostic procedure needs to be viewed in the context of all the other available diagnostic tools, and therefore has to be reevaluated periodically. This is also true of diagnostic laparoscopy, whether performed by gastroenterologists in patients under sedoanalgesia or by surgeons in patients under general anesthesia. Publications during the previous year have shed light on many important issues. Despite its greater expense, fluorescence laparoscopy may have advantages over white-light laparoscopy in the diagnosis of small tumor seeding. The unchanged superiority of laparoscopy over other imaging modalities for detecting small superficial liver metastases and peritoneal seeding has been clearly demonstrated. Whether cytological investigation of peritoneal washing can add relevant information to laparoscopy remains a matter of debate. Diagnostic laparoscopy before surgery has proved to be effective in many fields, including traumatology. The use of diagnostic laparoscopy in certain clinical circumstances, such as the early postoperative period after major cardiac surgery using extracorporeal circulation, appears promising. A transgastric approach to the peritoneal cavity for diagnostic and therapeutic purposes, the feasibility of which has been demonstrated in a porcine model, is an exciting innovation with as yet unforeseeable implications.

References

• 1 Löning M, Diddens H, Küpker W. et al . Laparoscopic fluorescence detection of ovarian carcinoma metastases using 5-aminolevulinic acid-induced protoporphyrin IX.  Cancer. 2004;  100 1650-1656
  CrossrefPubMedGoogle Scholar
• 2 Kalloo A N, Singh V K, Jagannath S B. et al . Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity.  Gastrointest Endosc. 2004;  60 114-117
  CrossrefPubMedGoogle Scholar
• 3 Denzer U, Hoffmann S, Helmreich-Becker I. et al . Minilaparoscopy in the diagnosis of peritoneal tumor spread: prospective controlled comparison with computed tomography.  Surg Endosc. 2004;  18 1067-1070
  PubMedGoogle Scholar
• 4 Schneider A RJ, Adamek H E, Layer G. et al . Staging of abdominal metastases in pancreatic carcinoma by diagnostic laparoscopy and magnetic resonance imaging.  Z Gastroenterol. 2003;  41 697-702
  Article in Thieme ConnectPubMedGoogle Scholar
• 5 Ozmen M M, Zulfikaroglu B, Ozalp N. et al . Staging laparoscopy for gastric cancer.  Surg Laparosc Endosc Percutan Tech. 2003;  13 241-244
  PubMedGoogle Scholar
• 6 Wilkiemeyer M B, Bieligk S C, Ashfaq R. et al . Laparoscopy alone is superior to peritoneal cytology in staging gastric and esophageal carcinoma.  Surg Endosc. 2004;  18 852-856
  PubMedGoogle Scholar
• 7 Weitz J, D’Angelica M, Jarnagin W. et al . Selective use of diagnostic laparoscopy prior to planned hepatectomy for patients with hepatocellular carcinoma.  Surgery. 2004;  135 273-281
  CrossrefPubMedGoogle Scholar
• 8 Dähn S, Schwalbach P, Wöhleke F. et al . Influence of different gases used for laparoscopy (helium, carbon dioxide, room air, xenon) on tumor volume, proliferation, and apoptosis.  Surg Endosc. 2003;  17 1653-1657
  CrossrefPubMedGoogle Scholar
• 9 Truncer K, Akarca U S, Aktas E Ö. et al . Detection of a foreign body during laparoscopy for differential diagnosis in a patient with ascites.  Endoscopy. 2004;  36 92
  Article in Thieme ConnectPubMedGoogle Scholar
• 10 Franklin M E, Gonzales J J, Jr, Miter D B. et al . Laparoscopic diagnosis and treatment of intestinal obstruction.  Surg Endosc. 2003;  18 25-30
  PubMedGoogle Scholar
• 11 DeCou J M, Gauderer M WL, Boyle J T. et al . Diagnostic laparoscopy with planned appendectomy: an integral step in the evaluation of unexplained right lower quadrant pain.  Pediatr Surg Int. 2004;  20 123-126
  CrossrefPubMedGoogle Scholar
• 12 Van Dalen R, Bagshaw P F, Dobbs B R. et al . The utility of laparoscopy in the diagnosis of acute appendicitis in women of reproductive age.  Surg Endosc. 2003;  17 1311-1313
  CrossrefPubMedGoogle Scholar
• 13 Onders R P, Mittendorf E A. Utility of laparoscopy in chronic abdominal pain.  Surgery. 2003;  134 549-552
  CrossrefPubMedGoogle Scholar
• 14 Chelly M R, Major K, Spivak J. et al . The value of laparoscopy in management of abdominal trauma.  Am Surg. 2003;  69 957-960
  PubMedGoogle Scholar
• 15 Hackert T, Kienle P, Weitz J. et al . Accuracy of diagnostic laparoscopy for early diagnosis of abdominal complications after cardiac surgery.  Surg Endosc. 2003;  17 1671-1674
  CrossrefPubMedGoogle Scholar
• 16 Velanovich V. The effects of staging laparoscopy on trocar site and peritoneal recurrence of pancreatic cancer.  Surg Endosc. 2004;  18 310-313
  CrossrefPubMedGoogle Scholar
• 17 Metcalfe M, Close J, Iswariah H. et al . The value of laparoscopic staging for patients with colorectal metastases.  Arch Surg. 2003;  138 770-772
  PubMedGoogle Scholar
• 18 Berber E, Garland A M, Engle K L. et al . Laparoscopic ultrasonography and biopsy of hepatic tumors in 310 patients.  Am J Surg. 2004;  187 213-218
  CrossrefPubMedGoogle Scholar
• 19 Fabiani P, Iannelli A, Mazza D V. et al . Diagnostic and therapeutic laparoscopy for stab wounds of the anterior abdomen.  J Laparoendosc Adv Surg Tech A. 2003;  13 309-312
  CrossrefPubMedGoogle Scholar
• 20 Van de Walle P, Blomme Y, van Outryve L. Laparoscopy and primary diffuse malignant peritoneal mesothelioma: a diagnostic challenge.  Acta Chir Belg. 2004;  104 114-117
  PubMedGoogle Scholar
• 21 Van den Broek W T, van de Ende E D, Bijnen A B. et al . Which children could benefit from additional diagnostic tools in case of suspected appendicitis?.  J Pediatr Surg. 2004;  39 570-574
  CrossrefPubMedGoogle Scholar
• 22 Udwadia T E. Diagnostic laparoscopy.  Surg Endosc. 2004;  18 6-10
  CrossrefPubMedGoogle Scholar
• 23 Sliecchia G, Raparelli L, Perrotta N. et al . Accuracy of laparoscopy in the diagnosis and staging of lymphoproliferative diseases.  World J Surg. 2003;  27 653-658
  CrossrefPubMedGoogle Scholar
• 24 Schwarte L A, Scheeren T WL, Lorenz C. et al . Moderate increase in intra-abdominal pressure attenuates gastric mucosal oxygen saturation in patients undergoing laparoscopy.  Anesthesiology. 2004;  5 1081-1087
  PubMedGoogle Scholar
• 25 Lang B HH, Poon R TP, Fan S T. et al . Influence of laparoscopy on postoperative recurrence and survival in patients with ruptured hepatocellular carcinoma undergoing hepatic resection.  Br J Surg. 2004;  91 444-449
  CrossrefPubMedGoogle Scholar
• 26 De Castro S MM, Tilleman E HGM, Busch O RC. et al . Diagnostic laparoscopy for primary and secondary liver malignancies: impact of improved imaging and changed criteria for resection.  Ann Surg Oncol. 2004;  11 522-529
  CrossrefPubMedGoogle Scholar

U. Weickert, M. D.

Dept. of Internal Medicine C, Klinikum Ludwigshafen

Academic Hospital of the University of Mainz · Bremserstraße 79 · 67063 Ludwigshafen am Rhein · Germany

Fax: +49-621-503-4114

Email: weickeru@klilu.de