诊断性腹腔镜检查

定义

诊断性腹腔镜检查 is a procedure that allows a doctor to look directly at the contents of the abdomen or pelvis.

选择的名字

Laparoscopy - diagnostic; Exploratory laparoscopy

如何执行测试

The procedure is usually done in the hospital or outpatient surgical center under 全身麻醉 (while you are asleep and pain-free). The procedure is performed in the following way:

• The surgeon makes a small cut (incision) below the belly button.
• A needle or hollow tube called a trocar is inserted into the incision. Carbon dioxide gas is passed into the abdomen through the needle or tube. 气体有助于扩大面积, giving the surgeon more room to work, and helps the surgeon see the organs more clearly.
• A tiny video camera (laparoscope) is then placed through the trocar and is used to see the inside of your pelvis and abdomen. More small cuts may be made if other instruments are needed to get a better view of certain organs.
• If you are having gynecologic laparoscopy, dye may be injected into your cervix so the surgeon can view the fallopian tubes.
• After the exam, the gas, laparoscope, and instruments are removed, and the cuts are closed. You will have bandages over those areas.

如何准备考试

Follow instructions on not eating and drinking before surgery.

You may need to stop taking medicines, 包括麻醉止痛药, 在考试当天或之前. DO NOT change or stop taking any medicines without first talking to your health care provider.

Follow any other instructions for how to prepare for the procedure.

考试的感觉如何

You will feel no pain during the procedure. Afterward, the incisions may be sore. Your doctor may prescribe a pain reliever.

You may also have shoulder pain for a few days. The gas used during the procedure can irritate the diaphragm, which shares some of the same nerves as the shoulder. You may also have an increased urge to urinate, since the gas can put pressure on the bladder.

You will recover for a few hours at the hospital before going home. You will probably not stay overnight after a laparoscopy.

You will not be allowed to drive home. Someone should be available to take you home after the procedure.

为什么要进行测试

诊断性腹腔镜检查 is often done for the following:

• Find the cause of pain or a growth in the abdomen and pelvic area when x-ray or ultrasound results aren't clear.
• After an accident to see if there is injury to any organs in the abdomen.
• Before procedures to treat 癌症 to find out if the 癌症 已经扩散. 如果是这样，治疗方法就会改变.

正常的结果

The laparoscopy is normal if there is no blood in the abdomen, 没有疝, 无肠梗阻, and no 癌症 in any visible organs. The uterus, fallopian tubes, and ovaries are of normal size, shape, and color. 肝脏正常.

异常结果意味着什么

Abnormal results may be due to a number of different conditions, including:

• Scar tissue inside the abdomen or pelvis (粘连)
• 阑尾炎
• Cells from inside the uterus growing in other areas (子宫内膜异位)
• Inflammation of the gallbladder (cholecystitis)
• 卵巢囊肿 或者是卵巢癌
• Infection of the uterus, ovaries, or fallopian tubes (盆腔炎)
• 受伤的迹象
• 癌症扩散
• 肿瘤
• Non癌症ous tumors of the uterus such as fibroids

风险

有感染的危险. You may get antibiotics to prevent this complication.

There is a risk of puncturing an organ. This could cause the contents of the intestines to leak. There may also be bleeding into the abdominal cavity. These complications could require immediate open surgery to treat them (剖腹手术).

诊断性腹腔镜检查 may not be possible if you have a swollen bowel, 腹部积液(腹水), 或者你过去做过手术.

参考文献

法尔科恩T，沃尔特斯医学博士. 诊断性腹腔镜检查. 见:Baggish MS, Karram MM编. Atlas of Pelvic Anatomy and Gynecologic Surgery. 5日艾德. Philadelphia, PA: Elsevier; 2021:chap 115.

Velasco JM, Ballo R, Hood K, Jolley J, Rinewalt D, Veenstra B. Exploratory 剖腹手术 - laparoscopic. In: Velasco JM, Ballo R, Hood K, Jolley J, Rinewalt D, Veenstra B, consulting eds. 基本外科手术. Philadelphia, PA: Elsevier; 2016:chap 1.