Pelvic laparoscopy is a surgical procedure that examines and treats pelvic organs through a small surgical viewing instrument (laparoscope) inserted into the abdomen at the navel.

While you are deep asleep and pain-free under general anesthesia, the doctor makes a half-inch surgical cut in the skin below the navel. Carbon dioxide gas is pumped into the abdomen to help the doctor see the organs more easily.

The laparoscope, an instrument that looks like a small telescope on a flexible tube, is inserted so the doctor can view the area. Other instruments may be inserted through other small cuts in the lower abdomen to get tissue samples or do other procedures. After the laparoscopy, the carbon dioxide gas is released, and the surgeon closes the cuts with stitches.

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

• Diagnosing a woman who may have appendicitis or salpingitis
• Evaluating infertility
• Looking at and removing an abnormal pelvic mass found on abdominal ultrasound
• Pelvic pain due to:
  • Infections (pelvic inflammatory disease) that don't respond to drug therapy
  • Uterine tissue found outside the uterus in the abdomen (endometriosis)
  • Ovarian cyst
  • Scar tissue (adhesions) in pelvis
  • Suspected twisting (torsion) of an ovary
• Puncture (perforation) of the uterus after a D and C or by an IUD
• Removing the uterus (hysterectomy)
• Removing uterine fibroids (myomectomy)
• Sterilization (tubal ligation)
• Surgically treating a tubal pregnancy

Pelvic laparoscopy is not recommended for patients with:

• Severe obesity
• Severe adhesions in the pelvis from other surgeries

General anesthesia poses the risk of reactions to medications, including breathing problems. Risks for any surgery include:

• Bleeding
• Damage to nearby organs and tissues
• Infection

Laparoscopic procedures are growing more popular with doctors, especially with the introduction of more high-tech laparoscopes.

Many of the procedures can be done the same day on an outpatient basis, but you may need to stay overnight. The average time of surgery is about an hour, but this depends on the procedure performed.

Whether used to diagnose or treat conditions, laparoscopy may prevent the need for a large surgical cut in the abdomen and a longer hospital stay. Laparoscopic surgery can be considered major surgery, depending on the procedure.

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

The gas pumped into the abdomen may cause abdominal discomfort for 1 - 2 days after the procedure. Some people feel neck and shoulder pain for several days after a laparoscopy as the carbon dioxide gas escapes through the skin.

You may resume your normal activities in fewer than 2 days. You can begin sexual activities again as soon as bleeding (if there is any) has stopped.

Call your doctor if you have:

• Bleeding from the vagina
• Fever that doesn't go away
• Severe abdominal pain

Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby; 2007.