World Journal of Laparoscopic Surgery

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VOLUME 14 , ISSUE 2 ( May-August, 2021 ) > List of Articles

Original Article

Role of Diagnostic Laparoscopy in Nonspecific Chronic Pain Abdomen

Subhash, Tanweer Karim, Nabal K Mishra, Gaurav Patel, Subhajeet Dey

Keywords : Diagnostic laparoscopy, Nonspecific chronic pain abdomen, NCPA, chronic pelvic pain

Citation Information : S, Karim T, Mishra NK, Patel G, Dey S. Role of Diagnostic Laparoscopy in Nonspecific Chronic Pain Abdomen. World J Lap Surg 2021; 14 (2):81-86.

DOI: 10.5005/jp-journals-10033-1464

License: CC BY-NC 4.0

Published Online: 19-08-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Introduction: Laparoscopy has established its role (diagnostic as well as therapeutic role) in patients with nonspecific chronic pain abdomen. In case of diagnostic dilemma and uncertainty, use of laparoscopy can help to avoid unnecessary laparotomy, provides accurate diagnosis, and helps to plan for surgical intervention if required. However, the role of laparoscopy in nonspecific chronic pain abdomen is still debated. Aims and objectives: To assess the accuracy of laparoscopy in the diagnosis of nonspecific chronic pain abdomen and its ability to avoid unnecessary exploratory laparotomy with complications and limitations associated with laparoscopy including failure rate. Materials and methods: This prospective descriptive study was conducted for a period of 1 year in patients with nonspecific chronic pain abdomen for more than 3 months attending the outpatient department or emergency department when clinical features and investigations are not conclusive. Results: Sixty-two patients in age-group from 15 to 60 years were studied. Overall 85.48% of patients had resolution of pain after diagnostic laparoscopy with diagnostic accuracy in our study of 88.7%. Conclusion: Diagnostic laparoscopy should be considered as one of the gold standard tests for diagnosing the nonspecific chronic pain abdomen, when noninvasive diagnostic modality failed in diagnosing cause.

  1. Camilleri M. Management of patients with chronic abdominal pain in clinical practice. Neurogastroenterol Motil 2006;18(7):499–506. DOI: 10.1111/j.1365-2982.2005.00744.x.
  2. Townsend CO, Sletten CD, Bruce BK, et al. Physical and emotional functioning of adult patients with chronic abdominal pain: comparison with patients with chronic back pain. J Pain 2005;6(2): 75–83. DOI: 10.1016/j.jpain.2004.10.009.
  3. Paajanen H, Julkunen K, Waris H. Laparoscopy in chronic abdominal pain. A prospective nonrandomized long-term follow-up study. J Clin Gastroenterol 2005;39(2):110–114. DOI: 10.1097/01.mcg.0000150174.88953.6e.
  4. Magni G, Rossi MR, Rigatti-Luchini S, et al. Chronic abdominal pain and depression. Epidemiologic findings in the United States. Hispanic health and nutrition examination survey. Pain 1992;49(1):77–85. DOI: 10.1016/0304-3959(92)90191-D.
  5. Irvin TT. Abdominal pain: a surgical audit of 1190 emergency admissions. Br J Surg 1989;76(11):1121–1125. DOI: 10.1002/bjs.1800761105.
  6. Reiter RC. Chronic pelvic pain. Clin Obstet Gynaecol 1990;33(1): 130–136. DOI: 10.1097/00003081-199003000-00018.
  7. Onders RP, Mittendorf EA. Utility of laparoscopy in chronic abdominal pain. Surgery 2003;134(4):552–554. DOI: 10.1016/s0039-6060(03)00277-0.
  8. Szomstein S, Lo Menzo E, Simpfendorfer C, et al. Laparoscopic lysis of adhesions. World J Surg 2006;30(4):535–540. DOI: 10.1007/s00268-005-7778-0.
  9. Salky BA, Edye MB. The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes. Surg Endosc 1998;12(7): 911–914. DOI: 10.1007/s004649900744.
  10. Swank DJ, Swank-Bordewijk SC, Hop WC, et al. Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. Lancet 2003;361(9365): 1247–1251. DOI: 10.1016/s0140-6736(03)12979-0.
  11. Nar AS, Bawa A, Mishra A, et al. Role of diagnostic laparoscopy in chronic abdominal conditions with uncertain diagnosis. Niger J Surg 2014;20(2):75–78. DOI: 10.4103/1117-6806.137301.
  12. Perri SG, Altillia F, Pietrangeli F, et al. Laproscopy in abdominal emergencies. Indications and limitations. Chir Ital 2002;54(2):165–178.
  13. Kerman US, Reddy KR. Diagnostic laparoscopy; an update. Endoscopy 2002;34(2):146–153. DOI: 10.1055/s-2002-19847.
  14. Ahmad MM, Dar HM, Waseem M, et al. Role of laparoscopy in nonspecific abdominal pain. Saudi Surg J 2014;2(3):71–74. DOI: 10.4103/2320-3846.147021.
  15. Mehta S, Juneja I, Udani D. Role of diagnostic laparoscopy in management of acute abdomen. Int J Surg 2009;20(1).
  16. Al-Akeely MH. The impact of elective diagnostic laparoscopy in chronic abdominal disorders. Saudi J Gastroenterol 2006;12(1):27–30. DOI: 10.4103/1319-3767.27741.
  17. El-Labban GM, Hokkam EN. The efficacy of laparoscopy in the diagnosis and management of chronic abdominal pain. J Minim Access Surg 2010;6(4):95–99. DOI: 10.4103/0972-9941.72594.
  18. Mustafa Ates, Sedat Sevil, Mahmut Bulbul. Routine use of laparoscopy in patients with clinically doubtful diagnosis of appendicitis. J Laparoendosc Adv Surg Tech 2008;18(2):189–193. DOI: 10.1089/lap.2007.0040.
  19. Fayez JA, Toy NJ, Flanagan TM. The appendix as the cause of chronic lower abdominal pain. Am J Obstet Gynecol 1995;172:122–123. DOI: 10.1016/0002-9378(95)90097-7.
  20. Raymond P, Onders MD, Elizabeth A, et al. Utility of laparoscopy in chronic abdominal pain. Surgery 2003;134(4):549–554. DOI: 10.1016/s0039-6060(03)00277-0.
  21. Palanivelu C. Diagnostic laparoscopy-indications, tuberculosis and adhesiolysis. In: Art of laparoscopic surgery. Textbook and atlas, vol. 1. 2007. p. 153–178.
  22. Rai S, Thomas WM. Diagnosis of abdominal tuberculosis the importance of laparoscopy. J R Soc Med 2003;96(12):586–588. DOI: 10.1258/jrsm.96.12.586.
  23. Arya PK, Gaur KJBS. Laparoscopy, a tool in diagnosis of lower abdominal pain. Indian J Surg 2004;66(4):216–220.
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