The liver is elevated using a probe
to allow visual inspection of the
gall bladder and bile duct.
Laparoscopy is used to examine the abdominal cavity. Laparoscopy is used to further evaluate patients with liver, biliary, pancreatic, adrenal, kidney or intestinal disease after performance of labwork and diagnostic imaging (abdominal radiographs and ultrasound). Laparoscopy is often used as a less invasive alternative to laparotomy (exploratory abdominal surgery).
Uses of Laparoscopy:
Diffusely swollen and inflamed pancreas
with evidence of omental saponification
(deposits of calcium complexed with fat
in nearby tissues).
In addition to allowing visual examination of organs in the abdominal cavity, laparoscopy can be used to:
Obtain bile for cytologic evaluation and culture.
Obtain tissue samples (biopsy) for cytologic and histologic evaluation. Samples are evaluated for inflammation, infection, fibrosis and cancer. Biopsy can aid in characterization the extent of disease. This generally takes three to five days.
Less-invasively perform abdominal surgeries, including gastropexy and ovariectomy.
A liver lobe is elevated for appropriate
clotting after laparoscopic biopsy
of discrete nodules.
Laparoscopy is performed under general anesthesia. The patient is generally fasted for 12 hours prior to laparoscopy to decrease the risk of aspiration of stomach contents into the lungs during anesthesia. After being anesthetized, the patient is placed in lateral recumbency (on its side) and anesthetic monitoring equipment is attached. The patientís heart rate and rhythm, respiratory rate, blood pressure, carbon dioxide level and oxygen saturation level are closely monitored while under anesthesia to prevent and minimize anesthesia-associated complications.
Anormally enlarged gall bladder extending
beyond the liver in a cat with pancreatitis.
The probe is being used to gently press on
the gall bladder to check for bile
After the patient is sterilely draped, two to three small (~1/4 inch) access ports are made through the body wall so a camera and instruments may be inserted into the abdomen. Carbon dioxide is used to insufflate (inflate) the abdomen, so the organs may be thoroughly examined. If identified, fluid may be removed from the abdomen using suction for analysis and to improve visualization. Photos and videos may be collected of normal and abnormal structures and motility for documentation and further study. A number of biopsy samples are generally collected from potentially abnormal organs for histopathology.
Laparoscopy generally takes between 30 minutes and one hour depending on gross findings and number of samples collected. At the end of the procedure, the laparoscope is slowly removed. The small incisions in the body wall are closed using absorbable sutures. The patient is then recovered from anesthesia. Many patients go home the day of the procedure.
Risks and Limitations:
Laparoscopy is generally considered a safe procedure. In addition to risks or limitations of endoscopy in general, the most common complication is mild discomfort at the sites of instrument insertion. Rarely, hemorrhage (bleeding) may occur during the procedure that would require surgical intervention.