Peritoneoscopy in general surgery.

Peritoneoscopy is a simple and effective means of diagnosing or excluding intra-abdominal disease. It is currently underutilized and merits increased recognition particularly by general surgeons. The first 77 peritoneoscopic examinations performed by a general surgeon in a large hospital associated with a cancer agency are reviewed. An exact diagnosis was made in 78% of 58 patients in whom the primary diagnosis was in doubt and in 93% of that group management was influenced. Surgical exploration of the abdomen was avoided in 29 patients. The major indications for using the method were: to search for metastases, to evaluate the acute abdomen and to stage lymphoma. Local anesthesia and nitrous oxide insufflation were used almost exclusively. Biopsy was performed in 36 patients and there was one death directly attributable to liver biopsy. In two patients peritoneoscopy was unsuccessful.