Office laparoscopy as a screening tool for early detection of ovarian cancer

Laparoscopy is a safe and effective surgical procedures used in evaluating the peritoneal cavity. Laparoscopy, under local anesthesia, has been well documented in the literature. These studies support the concept that laparoscopy can be performed under local anesthesia. Several small studies have addressed the respiratory, cardiac, and hemodynamic changes observed using local anesthesia and suggest that, with proper monitoring, these procedures can be safely performed in an outpatient setting. Optical catheter systems now have diameters ranging from 0.25 mm to 2.5 cm. Image fibers 6 microns in diameter are combined in bundles. The catheter system produces a brighter though grainier picture than views produced by a xenon light source and a 5 mm laparoscope. An Adair Verres needle (18 gauge) is inserted through a 3 mm plastic introducer. The Adair Verres needle is removed and a gas extension tube is used to create a pneumoperitoneum with carbon dioxide. The optical catheter is placed through the extension tube. If a second site is required for biopsy or washings, a 3 mm port can be inserted under direct visualization. Miniature ultrasound transducers have now been developed as a means of imaging the internal structures of the ovary. These transducers, housed in #3.5-6.2 French catheters, can be passed through a laparoscope, adding a new dimension to laparoscopy. Although the technology of office laparoscopy as a means of detecting early ovarian cancer exists, it has limited applicability for screening the population at large. It may be more useful as secondary or tertiary testing in the work-up of patients suspected of having ovarian cancer.