Impact of Laparoscopy in Malignant Lymphomas

Staging laparotomy was initially advocated from the late 1960s for patients with Hodgkin’s disease (HD), and some patients with non-Hodgkin’s lymphoma (NHL), to identify those patients who were potentially curable with radiotherapy and to accurately plan radiotherapy fields [1]. These procedures provided considerable information on the patterns and distribution of these diseases, altering the clinical staging in a significant group of patients [2, 3, 4, 5]. However, the role of laparotomy has been reduced with the introduction of computerized tomographic (CT) scanning and CT-directed percutaneous biopsy, the development of combination chemotherapy, and the increased use of combined modality therapy as well as the recognition of the morbidity of laparotomy [6, 7, 8]. The degree to which the role of laparotomy has diminished because the extra information gained has been rendered redundant by new treatment protocols or, alternatively, whether protocols have been developed excluding such information because of the associated morbidity is unclear.