'Seeing is believing': arguing for diagnostic laparoscopy as a diagnostic test for endometriosis

Jason Mak, Mathew Leonardi, George Condous
Reproduction & fertility · 2022 · vol. 3(3) , pp. C23–C28 · doi:10.1530/raf-21-0117 · PMID:35794928 · PMC9254269 · W4281759485
review OA: gold CC0 ⤵ 7 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This debate article argues for the use of diagnostic laparoscopy as the preferred method for definitively diagnosing endometriosis due to its safety and superior detection capabilities compared to medical imaging.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This commentary argues for diagnostic laparoscopy as a diagnostic test for endometriosis in people with chronic pelvic pain and/or infertility, reviewing evidence on procedural safety, diagnostic accuracy compared with imaging, and the value of both positive and negative findings. It cites low overall laparoscopic mortality and low complication rates from broad reviews and large cohorts, notes that diagnosis can validate patients’ symptom experiences and reduce diagnostic delay, and emphasizes that even a negative laparoscopy can expedite evaluation for non-endometriosis causes. The authors also summarize that while ultrasound and MRI can be used to help rule in endometriosis, a Cochrane review found neither imaging modality has sufficient accuracy to replace surgery for overall pelvic endometriosis, with performance varying by lesion depth and with ongoing advances for superficial disease; a key limitation is that much of the risk/accuracy evidence is drawn from heterogeneous studies and depends on individualized risk stratification and evolving techniques. This paper is centrally about endometriosis — it specifically argues that diagnostic laparoscopy should be maintained (including its role for both ruling in and ruling out endometriosis) as a diagnostic standard.

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Abstract

Endometriosis is a benign disease that can cause pain and infertility in women. Debate exists over how endometriosis should best be diagnosed. On one hand, endometriosis can be diagnosed by directly examining pelvic anatomy via a surgical procedure known as diagnostic laparoscopy. On the other hand, the disease can be diagnosed via non-surgical means such as using medical imaging, the symptoms described by the patient and whether the patient responds to non-surgical therapies such as medication. In this debate article, we argue in favour of diagnostic laparoscopy. We review the safety of the procedure, compare the ability of diagnostic laparoscopy vs medical imaging to detect endometriosis and consider the benefits of formally diagnosing or ruling out the condition.

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Condition tags

endometriosischronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (41)

Cited by (7)

Source provenance

europepmc
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License: CC0 · commercial use OK