Laparoscopy is a type of keyhole surgery. It allows a surgeon to look inside the pelvis and abdomen using a small camera.

In endometriosis care, laparoscopy may be used to diagnose endometriosis, assess where disease is, take biopsies, and sometimes treat endometriosis during the same operation.

Why laparoscopy may be considered

Laparoscopy may be considered when:

  • symptoms strongly suggest endometriosis
  • symptoms continue despite initial treatment
  • ultrasound or MRI is normal but symptoms continue
  • deep or complex disease needs assessment
  • fertility concerns are being investigated
  • surgery is being considered for treatment

The decision should be individual and based on symptoms, impact, imaging, preferences, fertility goals and specialist advice.

What happens during laparoscopy?

During laparoscopy, small cuts are usually made in the abdomen. A camera is inserted so the surgeon can inspect the pelvis and abdomen.

The surgeon may look for:

  • endometriosis lesions
  • endometriomas
  • adhesions
  • deep disease
  • bowel, bladder or ureter involvement
  • other possible causes of symptoms

If treatment has been agreed in advance, the surgeon may remove or treat endometriosis found during the operation.

Diagnostic and operative laparoscopy

A diagnostic laparoscopy means the main purpose is to look and diagnose.

An operative laparoscopy means treatment may also be performed, such as excision of lesions, treatment of adhesions or management of endometriomas.

Ask before surgery what is planned and what will happen if endometriosis is found.

Why surgeon experience matters

Endometriosis can appear in different colours, forms and locations. Some lesions are subtle. Deep, bowel, bladder, ureter, diaphragm or nerve-related disease may need specialist planning or additional surgeons.

Before surgery, ask whether the surgeon has experience diagnosing and treating endometriosis, including complex disease if suspected.

Excision and ablation

Two words you may hear are excision and ablation.

Excision means cutting out and removing endometriosis tissue.

Ablation means destroying tissue on the surface using heat or energy.

The right approach depends on the person, disease location, surgical findings and specialist advice. Ask which method is planned and why.

Biopsy and histology

If tissue is removed, it may be sent to a laboratory for histology. This means it is examined under a microscope.

Histology can help confirm endometriosis, but a negative result does not always exclude it.

Questions to ask before laparoscopy

You may want to ask:

  • Why is laparoscopy being recommended?
  • Is the aim diagnosis, treatment or both?
  • What areas will be inspected?
  • Will findings be recorded with images?
  • If endometriosis is found, will it be excised, ablated or left for later specialist surgery?
  • Will tissue be sent for histology?
  • What happens if bowel, bladder, ureter, diaphragm or other complex disease is found?
  • Would a multidisciplinary team be needed?
  • What are the risks and benefits?
  • What is the expected recovery?
  • What symptoms should I treat as urgent after surgery?

Use the Prepare for Appointment Tool

Use our Prepare for Appointment Tool before surgical discussions. It can help you organise symptoms, imaging results, questions, fertility goals and concerns.

Final reminder

Laparoscopy can be an important part of diagnosis and treatment for some people, but it should be discussed carefully.

You deserve to understand why it is being suggested, who will perform it, what will happen if endometriosis is found, and what the risks and benefits are.