Diagnostic laparoscopy: what to expect

Written by: Mr Dominic Coull
Published: | Updated: 11/08/2023
Edited by: Sophie Kennedy

Diagnostic laparoscopy is a procedure carried out under general anaesthetic to try and establish and perhaps also treat the cause of a patient’s symptoms of abdominal pain. A keyhole (laparoscopic) camera is inserted through a small incision, close to the belly button to identify any abnormalities within the abdomen and pelvis. In this article, highly experienced consultant laparoscopic, general and colorectal surgeon Mr Dominic Coull expertly outlines what patients can expect from the procedure.





What are the benefits of diagnostic laparoscopy?


The procedure offers the opportunity to identify and hopefully treat the previously unidentified cause of abdominal or pelvic pain. It allows a closer inspection of a lump or abnormal fluid that has been previously seen on a scan, helping to accurately diagnose tumours, ovarian cysts or pelvic infections.


It also allows assessment of chronic conditions such as Crohn’s disease, diverticular disease and endometriosis. If the cause of pain is scar tissue (adhesions) the operation will offer an opportunity for the surgeon to divide the adhesions, thus stopping the pain.


If the diagnostic laparoscopy doesn’t identify a cause of your symptoms, this reassures that there is no hidden sinister problem behind them. Around thirty per cent of patients attending hospital with abdominal pain and symptoms are diagnosed with non-specific abdominal pain which in eighty per cent of cases resolve themselves in the fullness of time.



Are there any alternatives to diagnostic laparoscopy?


The abdomen and pelvis can also be visualised with detailed scans such as CT and MRI. CT scans involve a significant amount of radiation and some patients are too claustrophobic to go in an enclosed MRI scanner. These scans are unable to identify every cause of abdominal pain and sometimes a diagnostic laparoscopy will still be necessary.



What does a diagnostic laparoscopy involve?


The operation is performed under general anaesthesia and usually takes thirty to sixty minutes. Your bladder may be emptied using a urinary catheter at the start of the operation. The surgeon will shave your abdomen at the time of surgery and you will also have a rectangular area of one thigh shaved to facilitate the safe usage of a surgical electrocautery device.


A keyhole (laparoscopic) camera is inserted through a small incision, close to the belly button and the abdominal cavity is then inflated with CO2 to give an optimal view of its contents, allowing the specialist to identify any abnormalities within the abdomen and pelvis. The surgeon will usually make one or two more small incisions to allow the entry of surgical instruments to perform the operation.



How can I optimise the chances of my successful surgery?


Patients should stop smoking completely for at least 2 weeks before surgery to reduce their risk of complications. Being overweight will increase your risk of complications but thirty minutes of exercise three times a week prior to surgery will improve your ability to cope with the anaesthetic.



What is the recovery period like after a diagnostic laparoscopy?


The day after surgery, patients could take a short walk if they feel comfortable without putting excessive strain on the wound. Driving and drinking alcohol should be avoided for the first twenty-four hours after the procedure. Surgeons usually apply surgical glue to most wounds which means that you can safely shower or bath from the day after surgery. They will also likely prescribe a pain killer to reduce any discomfort at the incision site.


If you develop any of the following symptoms after being discharged, you should contact your hospital urgently:

  • increasing pain
  • fever
  • vomiting
  • inability to pass urine or stools


If you would like to book an appointment with Mr Coull to discuss abdominal pain or the diagnostic laparoscopic procedure, you can do so by visiting his Top Doctors profile. 

By Mr Dominic Coull
Colorectal surgery

Mr Dominic Coull is a leading consultant laparoscopic general and colorectal surgeon whose main specialty is hernia surgery. He is based in Reading and is an examiner for The Royal College of Surgeons. Mr Coull's areas of expertise further lie in minimally-invasive hernia surgery, modern minimally-invasive management of haemorrhoids and colonoscopy alongside laparoscopic colorectal surgery, colorectal cancer and investigation of rectal bleeding. Mr Coull also specialises in altered bowel habits (diarrhoea, constipation), ulcerative colitis and Crohn's disease as well as pilonidal sinus surgery, anal fistula and anal fissure treatment and skin lesion removal.

He qualified in 1995 from the University of London and obtained a subsequent Masters of Surgery degree in Inflammatory Bowel Disease. After further training, he obtained a prestigious laparoscopic surgical fellowship in colorectal and general surgery jointly at two world-renowned surgical units in Basingstoke and Frimley, before being appointed as a consultant at the Royal Berkshire Hospital. Here, he initiated the provision of laparoscopic TEP hernia repairs and laparoscopic colorectal surgery there.

Mr Coull has acquired a vast amount of training and experience in his field and is considered an expert in laparoscopic surgery across Europe. Alongside his consultancy work, he is on the teaching faculty to train other European consultants at surgical training facilities in Paris, Hamburg and the UK.

He currently practices privately at the Circle Reading Hospital and Spire Dunedin Hospital. He prides himself on delivering first-rate, reassuring and honest consultations with his patients to support and guide them through their surgical procedures.

His average length of stay for patients following colorectal cancer surgery is three days contrasted with the national average of eight days. Additionally, his successful colonoscopy completion rate stands at 99 per cent - well above the national requirement of 90 per cent.

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