Laparoscopy In Abdominal Surgery Diagnostic And Therapeutic:

Soliman Abdeen Soliman

Laparoscopy is the visualization of the peritoneal cavity through the anterior abdominal wall with the use ofan endoscope after the induction of pneumoperitoneum.The aim of the work is an essay to study the modern useof laparoscopy as a safe and accurate diagnostic andtherapeutic procedure showing its advantages andlimitations.The literature has been reviewed concerning the historysince 1804 up to 1990, optical principles, instrumentationsfor laparoscopy. anaesthesia and indications which areclassified into:Diagnostic indications as in blunt and penetratingabdominal injury, acute abdomen, hepatobiliary disease,ascitis of unknown origin, tuberculous peritoneitis,palpable abdominal mass, fever of unknown origin, secondlook, abdominal diagnostic dilemma, chronic pain for unknwonorigin, oncology, cholangiography and in peritoneoscopicdisplacement of Tankhoff catheter for peritneal dialysis.Therapeutic indications as in cholecystectomy,cholecystostomy, drainage of amoebic liver abscess,adhesolysis, herniorrhaphy and appendicectomy.Contraindications to laparoscopy inc Iude abso Iutecontraindication as gross intestinal distension, refractoryblood dyscrasies, generalized peritonitis, decompensatedcardiorespiratory disease, abdominal wall sepsis, antigenpositive hepatitis, massive haemoperitoneum and massivehepatic insufficiency. Relative contraindications as hiatushernia, previous surgical scars, morbid obestiy, advancedpregnancy, huge intra-abdominal masses, immediate postpartumhaemorrhage and bleeding disorders. Complications oflaparoscopy include that of anaesthesia, creation ofpenumoperitoneum, trocar insertion, operative procedures andother miscellaneous complications.