Examination of the contents of the abdominopelvic cavity with a laparoscope passed through the abdominal wall.
Laparoscopy first became clinically practicable with the development of fiberoptics in the 1960s and of high-intensity, low-heat halogen bulbs in the 1970s. The technique has become standard, in selected cases, for many routine surgical procedures formerly requiring laparotomy, such as appendectomy, cholecystectomy, inguinal herniorrhaphy, oophorectomy, a second look after excision of an ovarian tumor, and diagnostic evaluation of endometriosis and female infertility. The peritoneal cavity is first inflated with CO2 gas, and the laparoscope passed through a small incision in the abdominal wall. One or two further incisions are usually required to provide surgical access to the area of interest. For some procedures a 6- to 8-cm incision may be made so that the surgeon can insert one hand. An elaborate armamentarium of surgical instruments has been developed to perform incision, drainage, excision, cautery, ligation, suturing, and other procedures with the laparoscope. The risk of intraoperative and postoperative complications, hospitalization time, and the cost of treatment are generally much less with laparoscopic surgery than with traditional open procedures.