Laparoscopy is usually performed through a small (1 centimeter) incision into the belly button with the patient under general anesthesia in the operating room. A camera is mounted to a long tube about as big around as one's first finger, which is placed into the incision in the belly button and into the abdominal cavity. Once inside carbon dioxide gas is used to expand the abdominal cavity so the internal organs can be visualized. The gynecologist either looks through the tube, or, more commonly, looks at a video monitor via the attached camera. A careful survey is made of the liver, appendix, the top layer of intestines, bladder, kidney tubes (ureters), and the gynecologic organs. Specifically, the gynecologic surgeon is able to fully visualize the uterus (womb), ovaries, fallopian tubes, rectum, and the bottom part of the cervix (the opening to the uterus) called the cul-de-sac. As one might imagine, this technique allows gynecologists to diagnose a large variety of important medical conditions.
Laparoscopy reduces pain, blood loss, scars and recovery time. During the procedure, a thin needle is placed into the abdomen through which carbon dioxide gas is introduced to inflate the abdominal cavity, giving the surgeon visibility and space to work. Surgeons make two to five dime-sized incisions into which they inserting hollow tubes called trocars. A specialized fiberoptic telescope with a video camera, called a laparoscope, is inserted through one of the trocars, allowing the surgeon to see inside the abdomen via a television monitor. The trocars are also used as paths for slender surgical instruments, and aid in the removal of cancerous growths and organs. In hand-assisted laparoscopy, a slightly larger incision allows the surgeon to insert a hand inside the abdomen to perform more complex surgery.