For Health Practitioners




A Laparoscopy is an operation used to look inside the abdomen and treat certain types of pelvic pain in women – especially endometriosis.

The operation is done under a general anaesthetic, which means you will be asleep the whole time. Once you are asleep, a small cut is made near your navel and two or three small cuts are made lower down.

The pictures below show the telescope inserted into the abdomen, and what can be seen during the laparoscopy. A laparoscopy gives a good view of the pelvic organs.

This picture shows the telescope inserted through the umbilicus and an instrument inserted lower down.
This picture shows the uterus, ovaries, fallopian tubes, pouch of Douglas and uterosacral ligaments at a laparoscopy.

A laparoscopy can show whether endometriosis is present, where it is and how severe it is. However, there are many types of pain that can’t be seen at a laparoscopy. Bladder pain, bowel pain, pelvic muscle pain, pain from the uterus and pain from nerve pathways can’t be seen at a laparoscopy.

Surgery for endometriosis

There are different types of surgery available to treat endometriosis. Which one is chosen will depend on where the endometriosis is and the choice of the surgeon doing the operation. Sometimes endometriosis is excised which means cut out and sometimes it is cauterised (diathermied) which means burnt.

Some laparoscopies for endometriosis are fairly short and straight forward, while others take much longer and are more difficult. It depends on where the endometriosis is and how severe it is.

Endometriosis in teens often looks different to endometriosis in older women, and can easily be missed. In older women it is often a dark brown colour. In young women it may look like tiny clear bubbles that can be hard to see.

We know that the amount of endometriosis found at a laparoscopy doesn’t fit with the amount of pain. So, you may have a little bit of endometriosis and a lot of pain, or a lot of endometriosis and very little pain.

We also know that women with endometriosis often have other pain problems as well. This might include a painful bladder, an irritable bowel, bad headaches, pelvic muscle pain, a painful vulva and pain on most days (chronic pain). These are pains that can’t be seen at a laparoscopy.

Removing the endometriosis lesions at a laparoscopy will treat pain due to the lesions themselves, but not pain coming from the other organs or the Chronic Pain condition.

Remember that even if you have endometriosis, that a lot of your period pain may also be from the uterus, even if the uterus looks normal.

It’s natural to think that if there is pain that there must be something to see, and that it should be able to be removed and ‘fixed’. Unfortunately that’s not true. There are some pains that can be seen at a laparoscopy and helped by surgery, and some which are just as painful but can’t be seen and can’t be helped by surgery. Good examples of this pain include pain from pelvic muscles, nerves, the bladder or the bowel.

Remember that it is not the small cuts on your abdomen that are the operation; it is what is done inside. Some laparoscopies are minor surgery, whereas other laparoscopies are major surgery through little holes.

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