Office microlaparoscopy under local anesthesia in the diagnosis and treatment of chronic pelvic pain

Abstract

Study objective: To evaluate the safety of diagnostic and operative microlaparoscopy performed in the office under local anesthesia in the diagnosis and treatment of chronic pelvic pain.

Design: Prospective study (Canadian Task Force classification II-2).

Setting: Office-based, free-standing private obstetrics and gynecology practice.

Patients: Twenty women with chronic pelvic pain.

Intervention: Diagnostic and operative microlaparoscopy performed under local anesthesia with conscious sedation.

Measurements and main results: All 20 patients had diagnostic microlaparoscopy and 19 had conscious pain mapping. Nine of 14 patients with endometriosis underwent fulguration of lesions and 7 of 8 with pelvic adhesions had lysis of adhesions. Four women with uterosacral ligament involvement had laparoscopic uterosacral nerve ablation. All patients tolerated office diagnostic and operative procedures without difficulty and had no complications.

Conclusion: In selected women, several laparoscopic procedures traditionally done in a hospital or ambulatory surgery center under general anesthesia can be performed safely in the office laparoscopy suite under local anesthesia with conscious sedation.