General

Synonym/Acronym:
Abdominal peritoneoscopy.

Rationale
To visualize and assess the liver, gallbladder, and spleen to assist with surgical interventions, staging tumor, and performing diagnostic biopsies.

Patient Preparation
Inform the patient that a laxative and cleansing enema may be needed the day before the procedure, with cleansing enemas on the morning of the procedure. There are no activity or medication restrictions unless by medical direction. Instruct the patient that to reduce the risk of aspiration related to nausea and vomiting, solid food and milk or milk products are restricted for at least 6 hr and clear liquids are restricted for at least 2 hr prior to general anesthesia, regional anesthesia, or sedation/analgesia (monitored anesthesia). The patient may be asked to be NPO after midnight. The American Society of Anesthesiologists has fasting guidelines for risk levels according to patient status. More information can be located at www.asahq.org.

Regarding the patient’s risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of medication taken. Protocols may vary among facilities.

Patients on beta blockers before the surgical procedure should be instructed to take their medication as ordered during the perioperative period.

Normal Findings

• Normal appearance of the liver, spleen, gallbladder, pancreas, and other abdominal contents.

Critical Findings and Potential Interventions

• Appendicitis

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.