Why diagnostic laparoscopy?

Introduction: Abdominal pain requires rapid diagnosis and treatment, especially in emergency circumstances. Sometimes the diagnosis of the disease cannot be accomplished with laboratory and imaging methods, and an invasive procedure such as diagnostic laparoscopy may be required to obtain a diagnosis. Although diagnostic laparoscopy can be performed for postdiagnosis treatment purposes, laparotomy is inevitable in some cases. Aim: The aim of the study is to evaluate the role of diagnostic laparoscopy in diagnosis and treatment and to retrospectively examine the factors that force the surgeon to perform a laparotomy. Material and methods: Patients over the age of 18 who underwent diagnostic laparoscopy in the general surgery clinic of Sakarya University Training and Research Hospital between January 2013 and December 2019 were retrospectively evaluated. Patients under 18 years of age and patients diagnosed before surgery were excluded. Demographic data of the patients, whether there was a conversion from laparoscopy to laparotomy, postoperative morbidity, and mortality were recorded. Results: The data of 347 patients in total were evaluated retrospectively between the specified dates. As many as 216 of the patients were previously diagnosed, with laparoscopic procedures performed for staging purposes and they were not included in the study. The remaining 131 patients were included in the study. Sixty-eight patients were women and 63 were men. In total 79.4% of the patients had diagnostic laparoscopies performed due to emergency circumstances, and 20.6% for abdominal pain evaluation. While the procedure was concluded laparoscopically in 64.9% of the patients, the operation was continued by performing laparotomy in 35.1%. Conclusion: Despite the increase in the variety and frequency of imaging modalities used, laparoscopic intervention is an essential approach in both diagnosis and treatment when the diagnosis is doubtful, especially in appropriate emergency cases