DIAGNOSTIC LAPAROSCOPY - A SURVEY OF 92 PATIENTS

From January 1991 to June 1993 the authors performed 92 diagnostic lap aroscopies when physical examination, laboratory tests, and noninvasiv e imaging techniques failed to provide accurate diagnoses. Thirty-thre e patients (36%) underwent laparoscopy to ensure or exclude diagnosis in suspected intra-abdominal malignancy or to assess the operability i n the cases of known cancer; 31 patients (34%) were evaluated for chro nic abdominal pain; 15 patients (16%) were evaluated for acute abdomin al pain; 9 trauma patients (10%) were evaluated to exclude or confirm penetration of the peritoneum or laceration of intra-abdominal organs; and 4 patients (4%) were operated on for miscellaneous conditions. Of the 92 patients, laparoscopy led to diagnosis in 80 patients (87%), a laparotomy was avoided in 78 patients (85%), and operative treatment was done laparoscopically in 65 patients (71%). Diagnostic laparoscopy will not replace laparotomy in every instance. However, in selected g roups of patients, it may be used to yield diagnosis and help avoid un necessary laparotomy.