What is Laparoscopy without
General Anesthesia?
Laparoscopy without General Anesthesia is a novel technique
that uses a small (2mm) laparoscope to visualize the peritoneal
cavity under local anesthesia at the bedside. This technique
may allow rapid and reliable diagnosis of abdominal injuries
or trauma, and therefore determine the need for further
surgery, without transport to the operating room, general
anesthesia or hospital admission.
This differs from traditional exploratory laparoscopy
in two ways. First, it does not require the abdomen to
be inflated with carbon dioxide. An inflated abdomen,
or pneumoperitoneum, provides a large operating space
for complex laparoscopic procedures. Instead, the abdominal
wall is elevated with instruments as the surgeon inspects
the cavity. Without the need for abdominal inflation,
the technique can be performed without general anesthesia.
The use of a small port allows insertion to be performed
under local anesthetic with conscious sedation in any
care setting.
Why perform Laparoscopy without
General Anesthesia?
The timely diagnosis of intra-abdominal pathology continues
to be an elusive problem. Delays in diagnosis and therapeutic
decision making are continuing dilemmas in patients who
are females of childbearing age, elderly, obese or the
immunocompromised. Laparoscopy without general anesthesia
potentially can provide an accurate, cost-effective method
to assist in the evaluation of patients with acute abdominal
pain. Laparoscopy without general anesthesia is not a
new technique, but with the combination of two emerging
factors--1) the introduction of new technology with the
development of improved, smaller laparoscopes and instruments,
and 2) the shifting of emphasis on healthcare to a more
cost-effective managed care environment--its value and
widespread utilization is being reconsidered.
To make
an appointment with Dr. Rosser, please call 212-420-4337.