An individual will receive a definitive diagnosis of endometriosis following a laparoscopy.1,2 A laparoscopy is a minimally invasive surgical procedure that involves inserting a small, thin, camera-containing device into the abdomen to view the structures inside. This device is called a laparoscope, and it sends real-time footage back to the surgeon performing the procedure so that they can identify and assess any issues.1,3,4 In relation to endometriosis, your surgeon will look for any endometriosis lesions within your pelvis. If they see anything abnormal, including potential endometriosis patches, they will take a small sample of this tissue and send it to a pathologist for further investigation. This is called a biopsy. A pathologist is someone who is trained in looking at tissues underneath a microscope in order to diagnose different conditions.
Laparoscopy with biopsy
As mentioned, during a laparoscopy, a laparoscope is inserted into the body. This is done through a small incision in the abdomen. The location of the incision can depend on what structures inside the body your provider is trying to get a closer look at. The procedure is performed by a surgeon, who may or may not be your gynecologist, depending on what your gynecologist has specialized in. The procedure is usually performed under general anesthesia, which means the person undergoing the laparoscopy is asleep. The abdomen is also filled with gas during a laparoscopy to allow for better viewing of the internal structures.3,4
While the procedure is underway, your surgeon will utilize the real-time footage from the laparoscope to identify any issues. If they come across something abnormal, they may take a small sample (biopsy) to be sent to a pathologist for further investigation. The surgeon may biopsy several sites within the abdomen during one laparoscopy. During a laparoscopy, endometriosis lesions are often identified by sight due to their dark blue or black coloration, however, they may take on many different shapes, colors, and forms depending on their location and how advanced they are.1 This is why a biopsy, or multiple biopsies, may be needed to confirm a diagnosis. Endometriosis lesions may be removed or destroyed during a diagnostic laparoscopy with biopsy if you have given consent for your surgeon to do this prior to the procedure starting.
A diagnostic laparoscopy is typically an outpatient procedure, meaning the individual undergoing the procedure will go home the same day. After the procedure, you may feel sleepy or uncomfortable from any remaining gas inside your abdomen, as well as sore at your incision site. Many people are able to go back to their normal activities within a few days of the procedure.3,4
Diagnosing other conditions
Other than endometriosis, a laparoscopy can be used to diagnose a variety of other conditions, including ovarian cysts, uterine fibroids, pelvic inflammatory disease (PID), and fallopian tube blockages, among other female reproductive system-related issues.3 Outside of the female reproductive system, laparoscopies can be used to diagnosis appendicitis, abdominal masses, fluid in the abdominal cavity (also called ascites), liver disease, and more.4 Beyond being a diagnostic tool, laparoscopies can help treat many of these conditions without requiring a more invasive procedure. If treatment with laparoscopy is an option for your specific situation, it may lead to faster recovery times and fewer risks than other, more invasive options. Your doctor will be able to best help you assess what options are available to you, and what the benefits or risks are for each option.