By the time a doctor diagnoses peritoneal mesothelioma, most people have developed a buildup of fluid in the abdomen called ascites. The doctor may drain the fluid if it is causing discomfort or other problems in a procedure called paracentesis. This is done under local anesthetic.
The doctor can also use a sample of this fluid to look for cancer cells and diagnose peritoneal mesothelioma (and the type involved). Sometimes the doctor has to take more tissue from the area (a biopsy) to make a diagnosis because not enough cancer cells are in the fluid.
At Memorial Sloan-Kettering, an interventional radiologist would likely do this as an outpatient procedure that involves sedating you and using a needle passed through the skin to take sample tissue from the abdominal area.
If your treatment team decides it is unsafe to do this biopsy through the skin or if the biopsy is performed but is inconclusive, we may recommend a minimally invasive procedure known as laparoscopy to make a definitive diagnosis. When you are under general anesthesia, surgeons insert a tiny video camera through a small incision in your abdomen, and with instruments inserted through other small incisions, remove a small amount of tissue for the pathologist to examine. Most people recover from this procedure in one to three days, and some do not even need to stay in the hospital overnight.
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