As the first step, the abdomen is cleansed and draped appropriately for the surgical procedure. Thereafter, an instrument is placed in the uterus via the vagina. Carbon dioxide or nitrous oxide is then made to flow into the abdomen from just below the navel. This helps to push the abdominal wall and the bowels away from the pelvic organs and to enable the doctor to see these organs clearly. The thin and slender laparoscope is then inserted through a small incision made just below the belly button. This procedure also requires a second incision to allow entry of a smaller probe that will help to move the pelvic organs in order to get a clearer view. A laparoscopic procedure will, therefore, have two incisions to help the doctor visualize all the concerned organs clearly.
During the laparoscopy surgery, all the organs in the pelvis are inspected thoroughly: uterus, ovaries and the peritoneum (the abdominal wall). Other signs that the doctor looks for are endometriosis, adhesions, and tubercles. In case of abnormalities, the doctor attempts to correct them surgically or perform a biopsy and takes out samples of the affected tissues for further histological examination. A blue dye (methylene blue) that is injected through the uterus into the Fallopian tubes helps the doctor to determine if the tubes are open and will facilitate fertilization. Once the surgical procedure is complete, the gas tube is taken out and the skin is sutured to close the two small openings. If the openings are very small, then Band-Aids (not sutures) are used to close them.