Pelvic laparoscopy

Pelvic laparoscopy is surgery to examine the pelvic organs. It uses a viewing tool called a laparoscope. The surgery is also used to treat certain diseases of the pelvic organs.

While you are deep asleep and pain-free under general anesthesia, the surgeon (usually a gynecologist) makes a half-inch (1.25 centimeters) surgical cut in the skin below the belly button. Carbon dioxide gas is pumped into the abdomen to help the surgeon see the organs more easily.

The laparoscope, an instrument that looks like a small telescope with a light and a video camera, is inserted so the surgeon can view the area.

Other instruments may be inserted through other small cuts in the lower abdomen. While watching a video monitor, the surgeon is able to:

• Take tissue samples (biopsy)
• Look for the cause of any symptoms
• Remove scar tissue or other abnormal tissue, such as from endometriosis
• Repair or remove part or all of the ovaries or fallopian tubes
• Repair or remove parts of the uterus
• Do other surgical procedures (such as appendectomy or removing lymph nodes)

After the laparoscopy, the carbon dioxide gas is released, and the cuts are closed.

Laparoscopy uses a smaller surgical cut than open surgery. Most people who have this procedure are able to return home the same day. The smaller incision also means that the recovery is faster. There is less blood loss with laparoscopic surgery and less pain after surgery.

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

• An abnormal pelvic mass or ovarian cyst found using pelvic ultrasound
• Cancer (ovarian, endometrial, or cervical) to see if it has spread, or to remove nearby lymph nodes or tissue
• Chronic (long-term) pelvic pain, if no other cause has been found
• Ectopic (tubal) pregnancy
• Endometriosis
• Difficulty getting pregnant or having a baby (infertility)
• Sudden, severe pelvic pain

A pelvic laparoscopy may also be done to:

• Remove your uterus (hysterectomy)
• Remove uterine fibroids (myomectomy)
• "Tie" your tubes (tubal ligation or sterilization)

Risks of any pelvic surgery include:

• Bleeding
• Blood clots in the leg or pelvic veins, which could travel to the lungs and, rarely, be fatal
• Breathing problems
• Damage to nearby organs and tissues
• Heart problems
• Infection

Laparoscopy is safer than an open procedure for correcting the problem.

Always tell your surgeon or nurse if:

• You are or could be pregnant
• You are taking any medicines, including medicines, drugs, herbs, or supplements you bought without a prescription
• You have been drinking a lot of alcohol, more than 1 drink a day

Planning for your surgery:

• If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see your health care provider who treats you for these conditions.
• If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
• Ask your surgeon if you need to arrange to have someone drive you home after your surgery.

During the days before surgery:

• You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
• Ask your surgeon which medicines you can still take on the day of your surgery.
• Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes outbreak, or other illness. If you do get sick, your surgery may need to be postponed.

On the day of your surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines your surgeon told you to take with a small sip of water.
• Your surgeon will tell you when to arrive at the hospital or clinic. Be sure to arrive on time.

You will spend some time in a recovery area as you wake up from the anesthesia.

Many people are able to go home the same day as the procedure. Sometimes, you may need to stay overnight, depending on what surgery was done using the laparoscope.

The gas pumped into the abdomen may cause abdominal discomfort for 1 to 2 days after the procedure. Some people feel neck and shoulder pain for several days after a laparoscopy because the carbon dioxide gas irritates the diaphragm. As the gas is absorbed, this pain will go away. Lying down can help decrease the pain.

You will get a prescription for pain medicine or be told what over-the-counter pain medicines you can take.

You may go back to your normal activities within 1 to 2 days. However, DO NOT lift anything over 10 pounds (4.5 kilograms) for 3 weeks after surgery to decrease your risk of getting a hernia in your incisions.

Depending on what procedure is done, you can usually begin sexual activities again as soon as any bleeding has stopped. If you have had a hysterectomy, you need to wait a longer period before having sexual intercourse again. Ask your surgeon what is recommended for the procedure you are having.

Contact your surgeon if you have:

• Bleeding from the vagina
• Fever that does not go away
• Nausea and vomiting
• Severe abdominal pain

Ali SN, Patel RM, Landman J. Fundamentals of laparoscopic and robotic urologic surgery. In: Dmochowski RR, Kavoussi LR, Peters CA, et al, eds. Campbell-Walsh-Wein Urology. 13th ed. Philadelphia, PA: Elsevier; 2026:chap 18.

Cohen JG, Bixel K, Backes FJ. Role of minimally invasive surgery in gynecologic malignancies. In: Creasman WT, Mutch DG, Mannel RS, Tewari KS, eds. DiSaia and Creasman Clinical Gynecologic Oncology. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 20.

Raymond L, Lentz GM. Endoscopy in minimally invasive gynecologic surgery. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 10.

Last reviewed on: 3/31/2024

LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.