Diagnostic laparoscopy.

Diagnostic laparoscopy is rapidly becoming a procedure used by general surgeons in increasing numbers. Its use will follow the therapeutic procedures now being used by many fellow surgeons. As the procedure is generally performed under local anesthesia, new techniques must be learned. The indications include abdominal pain (acute and chronic), focal liver disease, ascites, preoperative evaluation of malignant disease, and second-look evaluations after medical therapy for malignant disease. The overall diagnostic rate is 99% for acute abdominal pain, 70% for chronic pain syndromes, 95% for focal liver disease, 95% for abdominal masses, 97% for ascites, and greater than 80% for retroperitoneal disease. Diagnostic laparoscopy should be used with increasing frequency when a tissue diagnosis is needed.