While the patient is deep asleep and pain-free (general anesthesia), a one-half inch incision is made in the skin below the navel (umbilicus). Carbon dioxide is pumped into the abdomen to make the organs of the abdominal cavity more easily visible.

The laparoscope, an instrument similar to a small telescope on a flexible tube, is inserted so the area can be viewed. Other instruments used to obtain tissue samples or perform additional procedures may be inserted through small incisions made in the lower abdomen. After the laparoscopy, the carbon dioxide gas is released, and the incisions are stitched.

Pelvic laparoscopy is used both for diagnosis and for treatment and may be recommended for:

• pelvic pain due to
  • uterine tissue found outside the uterus in the abdomen (endometriosis)
  • infections (pelvic inflammatory disease) not responsive to drug therapy
  • suspected twisting (torsion) of an ovary
  • ovarian cyst
  • scar tissue (adhesions) in pelvis
• puncture through the uterus (uterine perforation) following D and C or by an IUD
• evaluation of infertility
• sterilization (tubal ligation)
• evaluation and removal of an abnormal pelvic mass (such as in a fallopian tube or ovary) that was confirmed previously by abdominal ultrasound
• removal of uterine fibroids (myomectomy)
• removal of uterus (hysterectomy)
• surgical treatment of tubal pregnancy in a hemodynamically stable patient
• evaluation of a woman who may have appendicitis or salpingitis

Pelvic laparoscopy is not recommended for patients with:

• severe obesity
• existing severe pelvic adhesions from previous surgeries

Risks for any anesthesia are:

• reactions to medications
• problems breathing

Risks for any surgery are:

• bleeding
• infection
• damage to adjacent organs

Laparoscopic procedures are growing more popular with physicians, especially with the advent of more "high-tech" laparoscopes.

Many of the procedures can be done on an outpatient basis, but an overnight stay may be necessary. The operating time averages 1 hour, but depends on the procedure performed.

Whether used as a diagnostic or as a therapeutic procedure, this procedure may avoid a large incision in the abdomen and a longer hospital stay. Laparoscopic surgery can be considered major surgery, depending on the procedure planned.

Unless major problems are uncovered during the procedure (such as severe bleeding, or certain cases of ectopic pregnancy), laparoscopy may be the only operation needed.

The gas pumped into the abdomen may cause abdominal discomfort for 1 or 2 days after the procedure.

Occasionally, neck and shoulder pain may be noted for several days after a laparoscopy as the carbon dioxide gas escapes through the skin. However, you should be back to normal activities in less than 2 days.

Sexual activities may resume as soon as bleeding, if any, has stopped. Call your doctor if you have severe abdominal pain, persistent fever, or vaginal bleeding.