“They Said They Found Nothing”: When a Laparoscopy for Endometriosis Misses Something or Causes Harm
Summary
Laparoscopy is the main way endometriosis is diagnosed and treated in Australia. For many people it brings answers and relief. This guide is for those told “nothing was found” who were later diagnosed with endometriosis, those whose surgery didn’t treat what was there, and those injured during the operation. It explains the procedure with a diagram of the pelvis, the risks, what should happen, and when it might point to care that fell short.
Quick answer · updated November 2026
A laparoscopy can diagnose and treat endometriosis in the same operation. But deep disease near the bowel, bladder or ureters can be missed or only partly treated, and injury to those organs is a recognised risk. If you were told nothing was found and symptoms continued, or you were injured, you can ask for the operation report, photos and pathology, and a second opinion.
Laparoscopy for endometriosis at a glance
- 1Before surgeryYour symptoms, scans and the surgeon’s experience should shape the plan.
- 2The operationThe pelvis is inspected. Disease is cut out or burned, and samples taken.
- 3The resultsYou should get the findings, photos and pathology explained.
- 4RecoverySteady improvement over days. Worsening pain is a warning sign.
- 5If symptoms continueAsk what was looked for, what wasn’t treated, and about a second opinion.
At any stage: tummy pain getting worse, fever, a racing heart, vomiting, leaking urine or pain on one side of the back after surgery needs urgent review.
I was twenty-eight and had spent half my life curled around a hot water bottle. When the gynaecologist finally booked me for a laparoscopy, I cried in the car park, because someone was going to look.
I woke up groggy, and a nurse I hadn’t met said the doctor had been by. “Good news. Everything looked pretty normal. Just a couple of tiny spots they burned off.”
At my follow-up, the gynaecologist said maybe it was my pelvic floor, or maybe stress. He suggested the pill again. I said I’d tried the pill for ten years. He said some people just have painful periods.
The pain was back within three months. Worse, now, when I went to the toilet. I started to wonder whether it was all in my head.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
If you were told your laparoscopy found little or nothing, and you are still in pain, I want you to know that you are not imagining it, and that “nothing found” is not always the end of the story. If you were injured during the operation, your questions about that are entirely reasonable too.
This guide is for anyone who has had, or is considering, laparoscopy for endometriosis. It covers what the operation involves, the risks, why disease can be missed or only partly treated, what you should be told afterwards, what your records should show, and how the law looks at it.
Why I can write this
I have been a medical negligence lawyer since 2014 and have worked on many hundreds of claims, including many involving gynaecology. My doctorate looked at patterns of failure in medical negligence. I am not medically qualified. The clinical facts in this article are checked against named sources, listed in the references, and I explain how I work in our editorial standards.
Start with your question
- What happens in a laparoscopy for endometriosis?
- Can endometriosis be missed during a laparoscopy?
- What is the difference between excision and ablation?
- What are the risks of laparoscopy for endometriosis?
- What symptoms after surgery are an emergency?
- Should I get a second opinion?
- Could this be medical negligence?
What the operation involves
Laparoscopy is keyhole surgery using small cuts and a tiny telescope. For endometriosis, it means diagnosis and treatment can happen in the same operation. If endometriosis is seen, a sample is usually removed and examined under the microscope to confirm the diagnosis.1
Where endometriosis is found, and what lies close by
The pelvis, seen from the front
Pink spots show common places endometriosis grows. Dotted lines are the ureters, the tubes carrying urine from the kidneys.
- The ovaries. Endometriosis can form cysts (endometriomas), which are usually removed.
- Behind the uterus. Deep disease here can involve the bowel and may be harder to see and to treat fully.
- Near the bladder and ureters. These organs sit close to the disease and can be injured during surgery.
A simplified drawing, not to scale. Endometriosis can grow in many places, and every person is different.
Excision and ablation
Definition
Excision means cutting endometriosis out. Ablation means destroying it with heat (diathermy). Excision is generally preferred where either is appropriate, because the tissue can then be examined under the microscope.1
In plain terms: cutting it out gives proof of what was there. Burning the surface may not reach deeper disease.
Before surgery
Before you agree, you should understand what the surgeon expects to find, what they plan to do, and what they will do if they find deep disease involving the bowel, bladder or ureters. The Royal Women’s Hospital notes that endometriosis affecting organs such as the bowel or ureter may not be fully treatable by laparoscopy and may need later surgery by other specialists.1
Questions to ask
- How much endometriosis surgery do you do, including deep disease?
- Will you excise, ablate, or both, and why?
- What will you do if you find disease on the bowel, bladder or ureters?
- Will you take photos and send samples to pathology?
- Who will explain the findings to me, and when?
The risks
Problems are rare but can be serious. The Royal Women’s Hospital gives these approximate figures: bleeding about 1 in 500; damage to organs such as the bladder, bowel, ureter, uterus, tubes, ovaries, blood vessels or nerves about 1 in 500; delayed diagnosis of organ damage needing a second operation about 1 in 3,000; and blood clots in the legs or lungs fewer than 1 in 100. Infection, scar tissue, and failure to treat all the endometriosis or improve symptoms are also listed.1
Recovery and warning signs
Most people improve steadily over the days after surgery. Pain that gets worse instead of better is a warning sign, because injuries to the bowel or ureter are sometimes not obvious at the time. Our guide to bowel injury during surgery explains why.
Expected, worth a review, or emergency
Usually expected
- Sore wounds and some bloating
- Shoulder-tip ache from the gas
- Light bleeding
- Tiredness for a week or two
In plain terms: sore, but improving.
Call your surgeon today
- Pain that isn’t settling
- Burning or difficulty passing urine
- Pain on one side of your back
- A red or weeping wound
In plain terms: ask to be seen, not just reassured over the phone.
Emergency
- Worsening pain across the tummy
- Fever, chills or a racing heart
- Vomiting and unable to keep fluids down
- Fluid leaking from the vagina or wounds
In plain terms: go to an emergency department and say what surgery you had.
Getting your results
After surgery, you are entitled to understand what was found and done. That includes the operation report, any photos or video taken, and the pathology results from any samples. If you are told “nothing was found”, ask exactly which areas were inspected, whether samples were taken, and what the pathology showed.
When “nothing was found” but symptoms continue
A laparoscopy that finds no endometriosis can be genuinely reassuring. But endometriosis can be subtle, can look different in different people, and deep disease can be hidden behind other organs. If your symptoms continue, it is reasonable to ask for a second opinion, ideally from a surgeon with experience in endometriosis. Our guide to suing for delayed diagnosis of endometriosis explains how the law looks at diagnosis that comes years too late.
Second opinions
A second opinion is not disloyal. It is part of making a decision about your own body. Bring your operation report, photos and pathology. If you felt dismissed, see when being dismissed by a doctor becomes a legal issue.
It took two more years and a different gynaecologist, one who did a lot of endometriosis surgery, before anyone explained it. She ordered a specialised ultrasound first. It showed nodules behind my uterus, against the bowel.
At the second operation she found deep endometriosis on my bowel and both ovaries stuck down. A bowel surgeon joined her in theatre. She showed me the photos afterwards.
When I got the records from the first laparoscopy, the note said “few superficial lesions, ablated. Pouch of Douglas not visualised, obscured.” No samples were sent. No photos. Nobody told me part of my pelvis hadn’t been seen.
My mum read the note with me at her dining table. “Not visualised,” she said. “They didn’t look. And they told you there was nothing.” I still have pain some days. But I know it isn’t in my head, and I know why it took so long.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
What to look for in the records
Your records are often where the story becomes clear. You have a right to access your own health information. In NSW the Health Records and Information Privacy Act 2002 covers both public and private providers, and the Information and Privacy Commission explains how to ask.2 Our step-by-step guide to getting your medical records in Australia walks you through it.
| Record | Why it matters |
|---|---|
| Pre-operative notes and scans | Show what symptoms you reported and whether specialised imaging was done before surgery. |
| Consent form | Shows whether risks, including injury to bowel, bladder or ureters, and the possibility of incomplete treatment, were explained. |
| Operation report | Records which areas were inspected, what was found, and whether excision or ablation was used. Look for phrases like “not visualised”. |
| Intra-operative photos or video | Show what the surgeon saw, and may be reviewed by a second surgeon. |
| Pathology report | Shows whether samples were taken and whether endometriosis was confirmed. |
| Follow-up notes | Show how the findings were explained to you and what plan was made. |
| Your own diary, photos and messages | Notes made at the time are evidence too. Keep them. |
How the law looks at it
A laparoscopy that doesn’t find or fully treat endometriosis, or that causes an injury, is not automatically negligence. Endometriosis can be hard to see, and injuries can happen with careful surgery. The legal questions are whether the surgery and the advice around it met the standard expected, and whether any shortfall caused harm.
A claim usually turns on three questions: whether the care fell below what peers would widely accept as competent practice (section 5O of the Civil Liability Act 2002 (NSW))3, whether that shortfall probably caused harm you wouldn't otherwise have had (Tabet v Gett)4, and, where it matters, whether you were told the material risks first (Rogers v Whitaker)56. Our guide to how a medical negligence claim works explains each one in plain terms.
In an endometriosis laparoscopy case, the questions might be: was the pelvis adequately inspected and the findings documented? Were samples sent to pathology? Was disease that could reasonably have been seen and treated missed? Were you told about areas that weren’t inspected or disease that wasn’t treated? Was an injury recognised and repaired promptly?
In plain terms, the question is whether better surgery or advice would probably have spared you years of pain, further operations, an injury, or harm to your fertility.
For laparoscopy, that would usually include the risks of injury, the chance that not all disease will be found or treated, and what will happen if deep disease is found.
Who can claim, and when
The person who had the surgery can claim. In NSW, time usually runs from when you knew, or ought to have known, enough to claim, not from the treatment itself, and courts can sometimes extend it, so an old injury may still count. See time limits in NSW or other states, and ask early.
More: complaint or claim? · how a claim is paid for · what a claim can cover
In my practice
In files about laparoscopy for endometriosis, I often find a gap between what was written in the operation report and what the patient was told. The report may say part of the pelvis was “not visualised”, or that lesions were burned without samples being taken. The patient, meanwhile, was told everything looked normal. Years later, a more experienced surgeon finds deep disease where the first never looked. Each step on its own can seem small. Together they can mean years of pain, being told it is stress, and a person beginning to doubt their own body. Reading the original operation report often changes how people feel about those years.
Both things can be true
Your first surgeon may have been well-intentioned and competent in many ways, and the operation may still have fallen short. Endometriosis may be hard to find, and you may still have deserved to be told what wasn’t looked at. You can be grateful to the surgeon who finally found it and still want to know why it took so long.
The bigger picture
Endometriosis has received growing national attention, with long delays in diagnosis widely recognised. Hospital patient information, such as the Royal Women’s Hospital fact sheet, is now clear that deep disease may need more than one specialist.1 You can check your surgeon’s registration on the Ahpra public register,7 and complaints about care in NSW can go to the Health Care Complaints Commission.8
Our endometriosis and gynaecology page brings together our guides in this area, including pelvic floor Botox and IUD insertion.
Support
You don't have to work through this alone. These services can help:
- Lifeline, 24-hour crisis support: 13 11 14 (listed on healthdirect's helplines page)9
- Beyond Blue, anxiety and depression support: 1300 22 4636
- Medicare Mental Health, help finding mental health support: 1800 595 212
- healthdirect, 24-hour nurse advice: 1800 022 222
- Health Care Complaints Commission (NSW): 1800 043 159
A young woman who began to think the pain was in her head now holds the operation report that shows it wasn’t. You deserve that certainty too.
With care,
Rosemary
Frequently asked questions
Can endometriosis be missed during a laparoscopy?
Yes. It can be subtle or hidden, especially deep disease behind the uterus. Ask what areas were inspected and whether samples were taken.
What is the difference between excision and ablation?
Excision cuts endometriosis out so it can be tested. Ablation burns it. Excision is generally preferred when either is suitable.
What are the risks of laparoscopy for endometriosis?
One Australian hospital quotes organ damage at about 1 in 500 and delayed diagnosis of that damage at about 1 in 3,000.
Can I get my laparoscopy photos?
Yes. You can ask for your operation report, photos and pathology results as part of your records.
Should I get a second opinion after a negative laparoscopy?
If symptoms continue, a second opinion from a surgeon experienced in endometriosis is reasonable.
Can I claim if my laparoscopy missed endometriosis?
You may well have a claim if the surgery or advice fell below the accepted standard and that caused harm.
Questions about your laparoscopy?
When you're ready, and not before, I can look at what happened and help you understand your options.
Contraception and gynaecology guides
- “They said they found nothing”: When a laparoscopy for endometriosis misses something or causes harm (you are here)
- “I can’t feel my implant anymore”: Nexplanon (Implanon NXT) problems
- “Was that pain normal?” When an IUD insertion goes wrong
- “The Botox made it worse”: Pelvic floor Botox side effects
- Depo-Provera and brain tumours: delayed warnings and harm
- Can you sue a doctor for delayed diagnosis of endometriosis?
Part of our guide to endometriosis and gynaecology. Not sure where you stand? Try the free claim checker.
References
- The Royal Women’s Hospital (Victoria). Laparoscopy and endometriosis.
- Information and Privacy Commission NSW. Fact sheet: Accessing your health information in NSW.
- Civil Liability Act 2002 (NSW) s 5O, Standard of care for professionals.
- Tabet v Gett [2010] HCA 12.
- Rogers v Whitaker [1992] HCA 58; (1992) 175 CLR 479.
- Australian Commission on Safety and Quality in Health Care. Informed consent.
- Australian Health Practitioner Regulation Agency. Register of practitioners.
- Health Care Complaints Commission NSW. Home page.
- healthdirect Australia. Mental health helplines.
Stories in this article are composites, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. They do not describe any individual client.
Dr Rosemary Listing, PhD (Law), Medical negligence lawyer since 2014 · Of Counsel, Peter Evans & Associates. Rosemary's doctorate examined patterns of failure in medical negligence, and she teaches health law at the University of Newcastle. She is not medically qualified. About Rosemary.
Last updated: 10 November 2026 · First published: 10 November 2026 · Next review: May 2027
Cite this article: Listing R. “They said they found nothing”: When a laparoscopy for endometriosis misses something or causes harm. Reframe Legal. Published 10 November 2026. https://reframelegal.com/endometriosis-laparoscopy-complications/
This article is general information, not legal or medical advice. It does not create a lawyer–client relationship. Speak to your treating clinicians about your health, and get legal advice about your own situation.
If you are in danger or need urgent medical help, call 000. For crisis support, call Lifeline on 13 11 14.
Legal services are provided by Peter Evans & Associates.