A Study on the Role of Diagnostic Laparoscopy in Nonspecific Abdominal Pain

Abstract Background: Nonspecific abdominal pain (NSAP) represents a frequent and challenging clinical problem in both acute and chronic care settings. Despite advances in laboratory investigations and imaging modalities, a substantial proportion of patients continue to remain undiagnosed, resulting in prolonged symptoms, repeated hospital visits, and empirical treatment. Diagnostic laparoscopy offers direct visualization of the abdominal cavity and has emerged as an effective modality for identifying underlying pathology and enabling simultaneous therapeutic intervention. Objectives: The objective of the study was to evaluate the diagnostic yield, therapeutic benefit, and clinical outcomes of diagnostic laparoscopy in patients presenting with NSAP. Materials and Methods: This prospective observational study included 77 patients presenting with NSAP who underwent diagnostic laparoscopy after inconclusive clinical evaluation and conventional investigations. The study was conducted in the Department of General Surgery at a tertiary care teaching hospital during the study period from 2022 to 2025. Data collected included demographic variables, duration of symptoms, prior surgical history, laboratory and imaging findings, intraoperative laparoscopic observations, therapeutic procedures performed, and postoperative outcomes. Statistical analysis was performed to assess associations between clinical variables and diagnostic yield. Results: Diagnostic laparoscopy provided a definitive diagnosis in 76.6% of patients. The most frequently identified pathologies were adhesions (29.9%), endometriosis (20.8%), chronic appendicitis (15.6%), and abdominal tuberculosis (10.4%). Therapeutic interventions were carried out during laparoscopy in a majority of patients, with adhesiolysis and biopsy being the most common procedures. Significant associations were observed between diagnostic yield and duration of symptoms, previous abdominal surgery, and elevated inflammatory markers. Postoperative outcomes were favorable, with complete symptom resolution observed in 75.3% of patients and minimal complications. Conclusion: Diagnostic laparoscopy is a safe, effective, and valuable modality in the evaluation and management of NSAP. Its ability to provide definitive diagnosis and allow immediate therapeutic intervention makes it a superior option when conventional diagnostic methods fail. Early consideration of diagnostic laparoscopy can reduce diagnostic uncertainty, avoid unnecessary laparotomies, and improve patient outcomes.