diagnostic laparoscopy

Diagnostic Laparoscopy

This means a laparoscopy that is scheduled to "look for things". There

is no reason outside of infertility to do the procedure.

I rarely perform a diagnostic laparoscopy. Why? Because I got tired of

doing them and finding nothing. As I consider diagnostic laparoscopy,

I think about the information I already have. Is the ultrasound

completely normal? Is there a history of pelvic infection? Is there a

history of pelvic pain? Is there a history of pelvic surgery? Is the

hysterogram normal? Some doctors will do a blood test for Chlamydia to

see if there was a past history of that infection.

If the answer to all of these questions is no, the odds of finding

something on laparoscopy is very low. Some reports say it's about 5%.

Before the comments come pouring in there are a few things to add.

First, a small amount of endometriosis will be identified in some

patients, but in most of those cases, it's not enough to shake a stick

at, and the laparoscopy will have been unnecessary. Second, there will

always be surprise cases, where pre-op everything was negative, and at

surgery there are adhesions and or endometriosis. I question some of

these cases. Were the pre-op tests reviewed carefully enough? For

example, a cyst of endometriosis(endometrioma) should be seen on the

pre-op ultrasound. Some of the cases are unquestionable; all was

negative but the surgery showed correctable findings. So here is the

balance question. Do many patients have unnecessary surgery to find

problems in a very few? If a diagnostic laparoscopy was recommended to

you, be sure to go over these issues with your doctor. Even a simple

laparoscopy can have unfortunate complications. It's not minor