Laparoscopy and laparotomy allow examination of the pelvic cavity and, when necessary, the repair or removal of diseased or injured structures. A laparoscopy, also known as a pelvic peritoneoscopy, involves the insertion of a laparoscope (a type of endoscope) through the abdominal wall close to the umbilicus. Recent advances in surgical equipment and techniques have made it possible for some abdominal surgical procedures, such as cholecystectomy and hysterectomy, to be performed using the laparoscopic approach.

In addition, a laparoscopy may be performed for tubal ligations, aspiration of ovarian cysts, ovarian biopsy, graafian follicle aspiration to retrieve ova for in vitro fertilization, cauterization of endometrial implants, lysis of adhesions, oophorectomy, and salpingectomy.

Laparoscopy may also help detect such abnormalities as cysts, adhesions, fibroids, and infection; identify the cause of pelvic pain; diagnose endometriosis, ectopic pregnancy, or pelvic inflammatory disease; and evaluate pelvic masses or the fallopian tubes of infertile patients.

A laparotomy—a general term for any surgical incision made into the abdominal wall—is used when the extent of abdominal injury or disease is unknown (referred to as an exploratory laparotomy), when extensive surgical repair is indicated, or for pelvic conditions untreatable by laparoscopy (such as the removal of very large endometrial implants). Laparotomy also allows resection of ovarian cysts containing endometrial tissue, thereby averting the risk of rupture.