By Giorgio Dagnini
Common part. development in laparoscopy (new tools, technical suggestions, integration among laparoscopy and sonography). designated part. conventional and current symptoms for laparoscopy. Laparoscopy inliver illnesses. Oncological lapaoscopy (diagnosis, staging and follow-up for malignant tumors). Emergency laparoscopy.
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Sample text
Prelaparoscopic sonography, longitudinal scan in left decubitus. 5 cm) can be seen with signs of vascular compression. Echo-guided fine-needle biopsy revealed nonneoplastic tissue and can be reached for biopsy. At laparoscopy the macroscopic findings were not clear but the biopsy showed a nodular focal hyperplasia, thus establishing a diagnosis. There are also cases in which laparoscopy is indicated, but where sonography demonstrates that the position of the lesion to be diagnosed will hinder endoscopic visualization.
The echolaparoscopic examination may confirm that the lesion is single, or it may demonstrate other nodules, thereby indicating that surgery should be reconsidered. 3. Suspected but not confirmed neoplasms of the pancreas or, more generally, of the retroperitoneum. 4. Staging of malignant tumors and follow-up during therapy. Echolaparoscopy can reveal overlooked metastases, thus correcting echographic and laparoscopic false negatives. 5. Where disease of the gallbladder and the extrahepatic biliary ducts is suspected but echographic and laparoscopic findings are negative.
However, CO 2 is not tolerated by the patient because it causes intense peritoneal irritation with serious disturbances. Where CO 2 is used, therefore, general anesthesia is necessary. Our experience has shown that N0 2 electrocoagulation entails no risks and that with it general anesthesia can be avoided. After an endoscopic operation the patient has bed rest until the following day, just as do patients from whom one or more biopsies have been taken under laparoscopic guidance. 2 Lysis of Adhesions for Diagnostic Purposes One of the most important and frequent causes of partial or total failure in laparoscopy is the finding of adhesions in the abdomen.