Role of videoscopic-assisted techniques in staging malignant diseases

Preoperative radiographic studies fail to uncover a significant number of patients with unresectable malignancies. Small peritoneal studs of tumor, lymph node involvement, and small liver metastases are common causes of understaging by imaging studies. Videoscopic staging offers a higher degree of accuracy among these patients, with minimal complications and a shorter recovery time than with exploratory laparotomy. The addition of laparoscopic sonography and peritoneal lavage may further increase sensitivity to unresectable disease. Staging videoscopy has been applied to hepatobiliary and gastrointestinal malignancies, pleural and pulmonary tumors, and gynecologic malignancies. The author believes that videoscopic staging will become increasingly common as it is further studied and the best applications are delineated.