Laparoscopy (Diagnostic)

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 14, 2026

Diagnostic laparoscopy is a minimally invasive surgical procedure that directly visualizes the peritoneal cavity, pelvic organs, and abdominal structures through small incisions using a camera-equipped scope. It is the gold-standard method for diagnosing endometriosis and pelvic adhesions, conditions that imaging alone frequently fails to detect. Definitive diagnosis of endometriosis requires direct visualization and histological confirmation by biopsy.¹

The procedure is typically performed under general anesthesia. A small incision at the umbilicus allows passage of the laparoscope; one or two additional ports provide instrument access. The surgeon systematically examines all visible pelvic and relevant abdominal surfaces. When findings warrant immediate intervention, diagnostic laparoscopy is often combined with operative laparoscopy in the same setting, sparing the patient a second procedure.

Standard-distance laparoscopy misses a significant proportion of endometriotic lesions, particularly early-stage, subtle, or atypical implants. Close-approach techniques such as near-contact laparoscopy improve detection by bringing the camera within close proximity to the peritoneal surface, allowing higher-magnification evaluation of suspicious tissue. NaProTechnology and IIRRM-trained surgeons commonly integrate this approach into systematic pelvic examination protocols to reduce missed disease.²

The decision to proceed to surgery requires careful clinical judgment. Diagnostic laparoscopy is generally indicated when there is clinical suspicion of endometriosis, pelvic adhesions, or other structural pathology that cannot be adequately characterized by imaging. When performed by a trained surgeon with the capacity for operative intervention, a single procedure can move a couple from diagnosis to treatment. The addition of adhesiolysis or excision in the same surgical episode depends on intraoperative findings and surgeon preparation.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.