Laparoscopy is the most common procedure used to diagnose and remove mild to moderate endometriosis. Instead of using a large abdominal incision, the surgeon inserts a lighted viewing instrument called a laparoscope through a small incision. If the surgeon needs better access,she makes one or two more small incisions for inserting other surgical instruments.If your doctor recommends a laparoscopy, it will be to: • View the internal organs to look for signs of endometriosis and other possible problems. This is the only way that endometriosis can be diagnosed with certainty. But a “no endometriosis” diagnosis is never certain. Growths (implants) can be tiny or hidden from the surgeon’s view. • Remove any visible endometriosis implants and scar tissue that may be causing pain or infertility. If an endometriosis cyst is found growing on an ovary (endometrioma), it is likely to be removed. Laparoscopy procedure You will be advised not to eat or drink for at least 8 hours before a laparoscopy. Laparoscopy is usually done under general anesthesia, although you can stay awake if you have local or spinal anesthetic. A gynecologist or surgeon performs the procedure. For a laparoscopy, the abdomen is inflated with gas (carbon dioxide or nitrous oxide). The gas, which is injected with a needle, pushes the abdominal wall away from the organs so that the surgeon can see them clearly. The surgeon then inserts a laparoscope through a small incision and examines the internal organs. Additional incisions may be used to insert instruments to move internal organs and structures for better viewing. The procedure usually takes 30 to 45 minutes.