Diagnostic laparoscopy permits a relatively atraumatic means of confirming malignancy and stage of disease by biopsy, brushings or washings, assessing the extent of spread, and also the likely success of intervention.
Other advantages include the fact that biopsies are taken under direct vision, so ensuring only suspicious regions are analysed; if necessary, resulting bleeding can be diathermied at the same time. All four regions of the abdomen can be readily reached: targets have included the liver, pancreas, omentum, mesentery, tumour masses and lymph nodes. Earlier diagnosis and recovery permit more rapid initiation of anti-cancer therapies.
Disadvantages relative to laparotomy include an inability to visualize retroperitoneal structures and the region above the liver. Complications can include tumour seeding. Contraindications include carcinomatosis, significant adhesions and uncorrectable coagulapathies.
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