Laparoscopy Explained
Looking beyond the scans
"A laparoscopy is the gold standard for diagnosing many conditions that cannot be seen on scans alone, including endometriosis, pelvic adhesions and some causes of infertility."
What is a laparoscopy?
A laparoscopy is a type of keyhole surgery that allows a surgeon to look directly inside your pelvis and abdomen.
Unlike scans or X-rays, a laparoscopy allows doctors to see your reproductive organs with their own eyes.
This includes:
The uterus (womb)
The ovaries
The fallopian tubes
The lining of the pelvis
Nearby organs such as the bladder and bowel
It is performed under a general anaesthetic, so you will be asleep throughout the procedure.
Why is a laparoscopy done?
A laparoscopy may be recommended if you have:
Unexplained infertility
Suspected endometriosis
Chronic pelvic pain
Pain during sex
Persistent ovarian cysts
Suspected pelvic adhesions (scar tissue)
Suspected hydrosalpinx
Ectopic pregnancy
Unexplained findings on ultrasound or other investigations
Sometimes it is recommended when other tests have all appeared normal but symptoms continue.
What can a laparoscopy detect?
A laparoscopy can identify conditions that often cannot be diagnosed with scans alone, including:
Endometriosis
Pelvic adhesions (scar tissue)
Hydrosalpinx
Blocked or damaged fallopian tubes
Ovarian cysts
Fibroids on the outside of the uterus
Pelvic inflammatory disease (PID)
Congenital abnormalities
Some causes of chronic pelvic pain
It also allows doctors to assess how severe these conditions are.
Can treatment be carried out at the same time?
Often, yes.
One of the biggest advantages of laparoscopy is that diagnosis and treatment can frequently happen during the same operation.
Your surgeon may:
Remove endometriosis
Divide adhesions (scar tissue)
Remove ovarian cysts
Treat an ectopic pregnancy
Remove damaged fallopian tubes
Take tissue samples (biopsies)
This can reduce the need for further surgery.
How is the procedure performed?
After you are asleep:
A small cut is usually made near your belly button.
Carbon dioxide gas is used to gently inflate the abdomen, creating space for the surgeon to see clearly.
A tiny camera (laparoscope) is inserted.
One or more additional small incisions may be made for surgical instruments.
The surgeon carefully examines the pelvis and abdomen.
If necessary, treatment is carried out during the same procedure.
Most incisions are around 5–10 mm long.
How long does it take?
The procedure itself may take anywhere from 30 minutes to several hours, depending on whether treatment is required.
Many women go home the same day, while others stay overnight.
What is recovery like?
Recovery varies depending on what was done.
It is common to experience:
Tiredness
Mild abdominal pain
Shoulder tip pain (caused by the gas used during surgery)
Bloating
Light vaginal bleeding
Bruising around the small incisions
Most women gradually return to normal activities over one to two weeks, although recovery may take longer after more extensive surgery.
What are the risks?
Serious complications are uncommon but can include:
Infection
Bleeding
Blood clots
Damage to the bowel, bladder or blood vessels
Risks associated with a general anaesthetic
Your surgical team will explain these before your operation.
Why is laparoscopy considered the "gold standard" for endometriosis?
Although scans can sometimes suggest endometriosis, many lesions are simply too small or too well hidden to be seen on ultrasound or MRI.
A laparoscopy allows surgeons to inspect the pelvis directly.
If endometriosis is found, it can often be removed or biopsied during the same operation.
For many women, this is the investigation that finally provides an explanation for years of symptoms.
Can a normal laparoscopy rule everything out?
No.
A normal laparoscopy is reassuring, but it cannot explain every cause of infertility.
Infertility may still be related to:
Egg quality
Ovulation problems
Sperm factors
Hormonal conditions
Genetic factors
Implantation problems
Fertility is rarely explained by a single test alone.
Questions you may wish to ask your surgeon
Was any endometriosis found?
If so, what stage was it?
Were there any adhesions?
Were my fallopian tubes healthy?
Was a hydrosalpinx present?
Was any treatment carried out today?
Were biopsies taken?
What happens next?
Did you know?
Many women are told they have "unexplained infertility" simply because the underlying cause cannot be seen on blood tests or scans.
A laparoscopy is often the investigation that changes that diagnosis.
Georgina's Note ❤️
For almost twenty years, I was told I had unexplained infertility.
Blood tests were normal.
Ovulation was normal.
Scans gave few answers.
Then came surgery.
A laparoscopy finally revealed what the earlier investigations couldn't: endometriosis. It also became clear that both of my fallopian tubes had developed hydrosalpinges, leaving natural conception impossible.
For me, infertility wasn't unexplained at all.
The answers had been there—they simply hadn't been seen.
If there's one thing I hope you take from this page, it's this:
If your symptoms continue, or if something doesn't feel right, don't be afraid to ask whether further investigation is appropriate.
Sometimes the missing piece of the puzzle isn't a new symptom.
It's simply the right test.
And remember: if you're ever told that your infertility is "unexplained," it's okay to ask, "What has actually been ruled out?"
Because "unexplained" doesn't always mean there isn't a reason.
Sometimes it simply means the reason hasn't been found... yet.