A diagnostic laparoscopy is a procedure in which the laparoscopic surgeon uses the telescope to look at the organs and tissues inside abdominal cavity to arrive at a diagnosis.

When this surgical technique is used to confirm a particular diagnosis when in doubt, it is called a diagnostic laparoscopy. As a continuation, this technique allows for a definite treatment at the same time. This is called a therapeutic procedure. For example, a nineteen year old presents with right lower abdominal pain. The most common diagnostic dilemma is acute appendicitis versus right ovarian cyst. Here, laparoscopy provides not only diagnosis, but also correction of the problem at the same time.

Laparoscopic surgery, also called minimal access surgery (MAS), keyhole surgery is the latest surgical technique to perform operations on abdominal organs through small incisions (usually 0.5-1.5cm) as compared to larger incisions needed in traditional surgical techniques. This new technique enables direct visualization of the intra-abdominal organs and the peritoneum. 

Laparoscopic surgery is performed with the help of various medical equipments.

The different components required to see inside the abdomen include telescope, camera unit, carbon dioxide insufflator, light source and hand-held instruments.

The telescope is a long rigid instrument which allows the laparoscopic surgeon to view and examine the organs in the abdominal cavity. The size of the telescope varies from 2mm to 10mm. One end of the telescope passes inside the abdomen and provides an image. This image is transmitted along the entire length of the telescope. At the other end, the camera head is attached.

The camera unit consists of a camera base unit, camera head and its cable. The camera head passes the image from the telescope through its cable to the base unit. The base unit constructs the image which is transmitted to a medical monitor. Thus, the intra-abdominal image is viewed on the monitor.

Carbon dioxide (CO2) gas is put into the abdomen between the wall and the intestines through a special needle. This gas lifts the abdominal wall making it easier for the laparoscopic surgeon to see the organs during laparoscopy. The gas is removed at the end of the procedure.

Light is provided by a light source which transmits the light through a cable. This cable is attached to the telescope.

Hand held instruments pass through special ports to perform intricate movements required to perform a surgery.

In conventional surgery a long incision is made to gain entry into the abdominal cavity and operate. This result in increased post- operative pain, longer stay in hospital, delayed recovery, long and ugly scars, higher chance of wound infection, higher chance of hernia, delayed feeding after intestinal surgery. The incidence of all these is dramatically reduced by laparoscopic surgery.

Almost all surgeries being done in open surgery are nowadays being performed. The most common however are cholecystectomy (removal of the gall bladder), appendicectomy (removal of the appendix), tubal ligation (sterilisation), diagnostic laparoscopy, hernia repair, intestinal surgery.

Diagnostic laparoscopy can be done under local anesthesia, but the other procedures will require general anesthesia.

Usually blood tests are carried out on an out-patient basis. Thus, admission is done on the day of the surgery. Following an uncomplicated laparoscopic procedure for the gall bladder or appendix, the patient can discharged on the next day. For more advanced procedures, three to four days in hospital would be the norm.

If the surgery is uneventful, feeding can be started on the same day once the patient has recovered completely from the effects of anesthesia. Following a bowel surgery, feeding is delayed by three to four days. 

Usually seven days rest from the day of surgery should suffice. However, the laparoscopic surgeon is the best judge to advice based on your progress.

No. The advantage of this method as has been previously mentioned is that the incisions are very small, thereby reducing pain. Pain is the main deterrent for most patients. You can become ambulant as early as pain and anesthetic factors permit.

The equipment, maintenance and procedure are more expensive but as the hospital stay and the intake of drugs are reduced, it is actually the same if not less than open surgery.

It has become very common and is being done in almost every reputed hospital with minimal complication rates.

1.   There are some risks when you have general anesthesia.

2.   There is chance of infection or bleeding.

3.   The abdominal organs, glands, intestines, or blood vessels may be damaged if surgeon is not experienced

4.   The lining of the abdominal wall may become inflamed known as peritonitis

5.   A blood clot may enter the bloodstream, and clog an artery in the lung, pelvis, or legs.  Clot may break off and clog an artery in the heart or brain, causing a heart attack or stroke. But these risks are very rare.

Several procedures can be done by laparoscopy in children. Laparoscopy is most commonly done to find and treat the cause of abdominal pain in children when other investigations have not been helpful.  Appendicitis can be diagnosed and appendicectomy done laparoscopically.  It may be equally easy and safe to do an open appendicectomy. Other common indications are for treatment of benign ovarian cysts, undescended testis and when lower intestinal bleeding is suspected to be from a Meckel’s diverticulum. In advanced centres many major operations are done by minimal access techniques (as laparoscopy or keyhole surgery is called). Of these, the most useful has been laparoscopic fundoplication for gastro-oesophageal reflux, laparoscopic pyeloplasty.

Yes. Several procedures for ovarian cysts, uterine fibroid is performed laparoscopically. Also, tests for infertility are also done laparoscopically.