ROLE OF LAPAROSCOPY IN THE STAGING OF MALIGNANT DISEASE

The first laparoscopic endeavor for the evaluation of gastrointestinal disease was performed by Kelling of Dresden in the early 1900s. He described the technique of "coelioskopie" using a cystoscope to examine the abdominal cavities of dogs.44 The concept of creating a satisfactory pneumoperitoneum was supported by FerversZ4 in the 1930s, who advocated using oxygen or carbon dioxide rather than room air. In 1938, Veressn developed the spring-loaded needle, allowing for the safe instillation of gas into the peritoneal cavity.' During the first decade of the twentieth century, the concepts of pneumoperitoneum were applied, and the diagnostic utility of "laparoscopy" was reported by Jac0baeus,3~ who first coined the term. Jacobaeus indicated that, by using a laparoscope, diagnoses of cirrhosis, metastatic tumors, and tuberculous peritonitis could be confirmed. Other developments, including the introduction of the quartz light rod, whch enhanced light transmission, led to the wider application of laparoscopy. The development of the fiber-optic bundle paved the way for the rigid laparoscope. With the further advances of video endoscopy and the inclusion of television monitoring, current techniques of laparoscopy using improved imaging have led to applications in the diagnosis of abdominal malignancy.