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These diagnostic laparoscopy guidelines are a series of systematically developed statements to assist surgeons’ (and patients’) decisions about the appropriate use of diagnostic laparoscopy (DL) in specific clinical circumstances. The statements included in this guideline are the product of a systematic review of published work on the topic, and the recommendations are explicitly linked to the supporting evidence. The strengths and weaknesses of the available evidence are described and expert opinion sought where the evidence is lacking. This is an update of previous guidelines on this topic (SAGES publication #0012; last revision 2002) as new information has accumulated.
Clinical practice guidelines are intended to indicate the best available approach to medical conditions as established by systematic review of available data and expert opinion. The approach suggested may not be the only acceptable approach given the complexity of the health care environment. These guidelines are intended to be flexible, as the surgeon must always choose the approach best suited to the patient and variables in existence at the time of the decision. These guidelines are applicable to all physicians who are appropriately credentialed and address the clinical situation in question, regardless of specialty. Guidelines are developed under the auspices of SAGES and the guidelines committee and approved by the Board of Governors. The recommendations of each guideline undergo multidisciplinary review and are considered valid at the time of production based on the data available. Recent developments in medical research and practice pertinent to each guideline will be reviewed, and guidelines will be updated on a periodic basis.
Diagnostic laparoscopy is minimally invasive surgery for the diagnosis of intra-abdominal diseases. The procedure enables the direct inspection of large surface areas of intra-abdominal organs and facilitates obtaining biopsy specimens, cultures, and aspiration. Laparoscopic ultrasound can be used to evaluate deep organ parts that are not amenable to inspection. Diagnostic laparoscopy not only facilitates the diagnosis of intra-abdominal disease but also makes therapeutic intervention possible.