With easy availability of imaging, staging laparotomy, which was standard procedure for lymphomas, became obsolete. Staging laparoscopy may spare patients the morbidity of an unnecessary laparotomy and provide tissue to confirm the diagnosis of non-Hodgkin lymphoma or allow the surgical staging of Hodgkin lymphoma. Staging laparoscopy can also be used for patients who need laparoscopic splenectomy as treatment and may lead to less pain, faster recovery, and earlier time to definitive treatment.
Hodgkin’s lymphoma originates in one nodal group and spreads in a stepwise manner to contiguous nodal groups. Staging laparoscopy may be useful in determining the stage and location of the disease, as this may affect decisions regarding treatment, particularly the administration of chemotherapy.
In contrast, for non-Hodgkin lymphoma, the exact extent of the disease has less impact on the treatment course, and therefore, staging laparoscopy in non-Hodgkin lymphoma is less frequently performed. The primary indication for staging laparoscopy in non-Hodgkin lymphoma is for tissue diagnosis through biopsy of intra-abdominal lymph nodes in the absence of peripheral lymphadenopathy. Retroperiteal or mediastinal lymphadenopathy with failed diagnosis on truecut biopsy is an indication for diagnostic scopy and biopsy of the lymphnodes