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

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.