Diagnosis and Staging of Tumors by Laparoscopy

Abstract

The reported experience over several decades from various surgical specialties indicate that laparoscopy is useful both in the diagnosis and staging of intra-abdominal tumors. The staging potential has been enhanced by the introduction of laparoscopic contact ultrasonography that is of special value in the scanning of solid organs and in the detection of small occult intraparenchymal deposits. Lymph node harvest is also possible in esophageal and gastric cancer, and the results of early studies on the value of pelvic lymphadenectomy in gynecological and urological malignancy have been encouraging. The use of laparoscopy as a second look after excision for intra-abdominal cancer may help detect early recurrent disease and has the potential for improving survival by enabling earlier intervention. The detection of inoperable cancer by laparoscopy not only spares the patient needless laparotomy, but also enables effective surgical palliation of obstructive symptoms by the minimal access approach. In selected patients with lymphomas in whom staging is required, laparoscopy with or without splenectomy is likely to supersede open laparotomy. Copyright © 1994 by W. B. Saunders Company