Diagnostic Laparoscopy

Publication Date: April 1, 2010
Last Updated: March 14, 2022

Technique

Many studies have documented the feasibility of the procedure. (, )
(levels II, III)
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Diagnostic Accuracy of the Procedure

The diagnostic accuracy of the procedure is high, ranging between 90 and 100% in the published series. (, )
The main limitation of the procedure is for the evaluation of retroperitoneal structures with the few false negative reported findings attributed to retroperitoneal processes like pancreatitis.
(level II, III)
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Nevertheless, the procedure appears to have excellent accuracy when evaluating for two of the most prevalent diseases in this population, acalculous cholecystitis and ischemic bowel. (, )
(level II, III)
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The procedure has been reported to prevent unnecessary laparotomies in 36-95% of patients. (Level III)
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Diagnostic laparoscopy has been compared with diagnostic peritoneal lavage and found to have superior diagnostic accuracy in critically ill patients. (Level II)
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It has also been found to be superior to computed tomography (CT) or ultrasound of the abdomen. (Level III)
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Procedure-related Complications and Patient Outcomes

The procedure can be performed safely, is well tolerated in ICU patients. (Level II)
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Recommendations

Diagnostic laparoscopy is technically feasible and can be applied safely in appropriated selected ICU patients. (, B)
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The procedure should be used in critically ill patients when an intra-abdominal catastrophe is suspected but cannot be ruled out by noninvasive means and would otherwise require an exploratory laparotomy. (, C)
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It should be given strong consideration in ICU patients with suspected acalculous cholecystitis or ischemic bowel, as its accuracy likely exceeds that of noninvasive studies. (C)
On the other hand, it should be kept in mind that the procedure is unlikely to identify retroperitoneal processes.
The decision to undertake DL and at which location (bedside or operating room) should be individualized and should be based on the available resources and laparoscopic expertise of the surgeon.
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Recommendation Grading

Overview

Title

Diagnostic Laparoscopy

Authoring Organization

Society of American Gastrointestinal and Endoscopic Surgeons

Publication Month/Year

April 1, 2010

Last Updated Month/Year

January 5, 2024

Supplemental Implementation Tools

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

These diagnostic laparoscopy guidelines are a series of systematically developed statements to assist surgeons’ (and patients’) decisions about the appropriate use of diagnostic laparoscopy (DL) in specific clinical circumstances. 

Target Patient Population

Patients with intra-abdominal disease

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Hospital, Operating and recovery room, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Diagnosis

Diseases/Conditions (MeSH)

D003954 - Diagnostic Services, D010535 - Laparoscopy, D020706 - Laparoscopes, D019719 - Diagnostic Equipment, D003949 - Diagnostic Techniques, Surgical

Keywords

laparoscopy, diagnostic

Source Citation

https://www.sages.org/publications/guidelines/guidelines-for-diagnostic-laparoscopy/