Laparoscopy and dye test

Summary

A laparoscopy and dye test is a keyhole procedure that lets your surgeon look directly at your womb, fallopian tubes and ovaries, and check whether the tubes are open. A coloured dye is passed through the cervix; if it spills freely from the ends of the tubes, they are open (patent). It is usually done as part of investigating difficulty in becoming pregnant.

• Done under general anaesthetic through 2–3 small cuts — about 1 cm at the navel and about 0.5 cm lower down.
• It takes about 15–30 minutes when nothing needs treating.
• It is the only test that both shows whether the tubes are open and lets the surgeon see the pelvis directly — so conditions such as endometriosis or adhesions are found at the same time.
• Many problems that are found can be treated in the same sitting, if you have agreed to this beforehand.
• You recover within a few hours and go home the same day; most women are back to normal activity within a few days.

This information supports discussion with your healthcare team. Reading, saving or printing it does not constitute consent to surgery.

About the procedure

The procedure has two parts done together:

• The laparoscopy — a thin telescope with a camera is passed through a small cut at the navel, giving a magnified view of the womb, both tubes, the ovaries and the lining of the pelvis on a screen.
• The dye test (chromopertubation) — a blue dye is injected through the cervix into the womb. The surgeon watches the ends of the tubes: dye spilling out means that tube is open; no spill suggests it is blocked, and where the dye stops shows roughly where.

A hysteroscopy — a look inside the womb cavity through the cervix — is often done at the same time, since no extra cuts are needed for it. Ask whether this is planned for you.

Why it is performed

Around 15% of married couples in Sri Lanka face difficulty in conceiving. Blocked or damaged tubes are a common and treatable cause, and they produce no symptoms — so they have to be looked for. This procedure is usually recommended when:

• You have been trying to conceive without success and earlier tests (semen analysis, hormone tests, ultrasound) have not explained why
• An X-ray dye test (HSG) was inconclusive, or suggested a blockage that needs confirming
• There is a reason to suspect tubal damage — past pelvic infection, a burst appendix, previous pelvic or tubal surgery, or an earlier ectopic pregnancy
• Endometriosis or pelvic adhesions are suspected from your symptoms — pelvic pain, painful periods or pain during intercourse
• You are being assessed before fertility treatment, or before surgery to the tubes

The main causes of tubal blockage are pelvic infection (PID), endometriosis, adhesions following earlier abdominal surgery, and previous tubal sterilisation.

Benefits

• A definite answer about your tubes — seen directly rather than inferred from an X-ray or scan.
• It finds what other tests miss. Endometriosis and adhesions cannot be diagnosed reliably by scan; here the surgeon sees them.
• Diagnosis and treatment in one anaesthetic — mild endometriosis can be treated, adhesions divided and simple cysts dealt with during the same procedure, avoiding a second operation.
• It guides your next step — whether to keep trying naturally, have tubal surgery, or move to IVF, which bypasses the tubes altogether.

Alternatives

• Hysterosalpingogram (HSG) — an X-ray dye test done awake, with no cuts and no anaesthetic. It shows the shape of the womb cavity and whether the tubes fill, but does not show the outside of the pelvis, so endometriosis and adhesions are missed.
• HyCoSy — an ultrasound-based tubal test, also done awake; same limitation.
• Going straight to treatment — in some situations (for example where IVF is likely to be needed anyway) it is reasonable to skip tubal testing and start treatment.
• Waiting. If you have been trying for a short time and there is no reason to suspect a problem, continuing to try is a valid choice.

Preparing for the procedure

You will have a pre-operative check: blood tests, blood pressure, and a review of your medicines and general health. Tell the team about all medicines you take and any previous surgery or anaesthetic problems.

• Timing in your cycle: the procedure is usually planned for the first half of the cycle, after your period has finished, so that an early pregnancy cannot be disturbed.
• Contraception: you may be asked to avoid unprotected intercourse from your last period until the procedure, for the same reason.
• Infection: any current pelvic or vaginal infection should be treated first, as the dye test can carry infection upwards.
• Fasting: exact instructions are given; typically no food from 6 hours before, water up to 2 hours before.
• At home: arrange for someone to take you home — you must not drive on the day of a general anaesthetic.

The day of the procedure

You are admitted on the day. The team confirms your identity and the plan, and you meet the anaesthetist and the surgeon. This is the time for last questions.

You will be asked to sign the consent form. For this procedure it is worth being clear in advance about how much treatment you want done if a problem is found — for example whether endometriosis should be treated, adhesions divided, or a cyst removed while you are asleep. Recording your wishes now avoids a second anaesthetic later. You can still change your mind at this point.

During the procedure

You are fully asleep under general anaesthetic and feel nothing. The abdomen is gently inflated with carbon dioxide gas to lift the abdominal wall away from the organs, and the telescope is passed through a small cut at the navel; one or two further tiny cuts low down allow a fine instrument to move the organs for a full view.

The surgeon inspects the womb, both tubes, both ovaries and the lining of the pelvis, then the dye is passed through the cervix and the ends of the tubes are watched. Findings are usually recorded as images or video for your file, and any treatment you have consented to is carried out at this point. At the end the gas is let out and the small cuts are closed with dissolvable stitches. A diagnostic procedure with nothing to treat commonly takes 15–30 minutes; longer if treatment is needed.

After the procedure

You wake in the recovery area. Shoulder-tip pain is common for a day or two — it comes from the gas and settles by itself; walking about helps.

• Pain relief: simple painkillers are usually enough for the cramping, which feels like period pain.
• Eating and drinking: the same day, once you are fully awake.
• Blue discharge: a little blue-stained vaginal discharge for a day or two is normal — it is the dye draining away, and is expected.
• Going home: the same day, once you have passed urine and eaten. Someone must take you home.
• Your results: the surgeon usually explains the findings before you leave, and again at a follow-up appointment with the images.

Understanding your results

• Both tubes open, pelvis normal — tubal blockage is excluded as a cause. Attention turns to other factors, and to how long you have been trying.
• One tube open — natural pregnancy is still possible, often with no treatment; your consultant will explain what the other tube's condition means for your chances.
• Both tubes blocked — depending on where and why, options are surgery to the tubes or IVF, which bypasses them. This is discussed with you rather than decided on the day.
• Endometriosis or adhesions found — these are graded and, where agreed, treated during the procedure; treatment can improve both pain and fertility.
• Spasm: occasionally a tube fails to fill because it goes into spasm rather than being blocked. Your surgeon can usually tell the difference, but sometimes a repeat or different test is advised.

Recovery at home

• First few days: mild cramping, tiredness and bruising around the tiny cuts are normal; most women are back to normal activity within 2–3 days.
• Work: commonly 2–3 days off after a purely diagnostic procedure; longer if treatment was carried out.
• Driving: not on the day of the anaesthetic; after that, once you can brake hard without hesitation — usually within a few days.
• Intercourse and swimming: once any bleeding or discharge has stopped and you feel comfortable.
• Trying to conceive: you can start trying again as soon as you feel well, unless you have been told otherwise. Ask whether your findings change the plan.

These are typical figures; your own advice may differ and comes first.

Risks and complications

This is a common, low-risk procedure, but it is still surgery under general anaesthetic. The figures below are averages from published UK guidance; your individual risk depends on your health, weight and any previous surgery.

Expected, temporary effects

• Period-like cramping for a day or two
• Shoulder-tip pain from the gas
• Blue-stained vaginal discharge as the dye drains
• Bruising and tenderness at the small cuts

Complications

• Infection — of the wounds, urine or pelvis; the dye test can occasionally carry infection upwards, which is why existing infection is treated first (uncommon).
• Injury to the bowel, bladder, ureter or a blood vessel while the instruments are inserted — recognised injuries are repaired, sometimes needing a larger cut (rare, and the main serious risk of any diagnostic laparoscopy).
• Bleeding from a port site or from tissue that was treated (uncommon).
• Blood clots in the leg or lung (VTE) — preventive measures are routine (rare after a short procedure).
• Hernia at a port site, later on (rare).
• An unclear result — occasionally the tubes cannot be assessed properly and a further test is needed.
• Anaesthetic risks — serious anaesthetic complications are rare in otherwise healthy women.

When to seek help

After you go home, seek medical advice the same day if you notice:

• Worsening abdominal pain not controlled by your painkillers
• Fever (38 °C or higher) or feeling increasingly unwell
• Heavy vaginal bleeding, or foul-smelling discharge
• A wound that becomes red, swollen, hot or leaks fluid
• Burning on passing urine, or being unable to pass urine
• Persistent vomiting, or a swollen, tense abdomen
• A painful, swollen or red leg

Preparing for your consent discussion

Consent is a conversation, not a signature. For this procedure the most important part of that conversation is what you want done if something is found while you are asleep. The checklist below is a starting point — print it and bring it to your consultation.

Sources and review

This page was drafted against the published guidance below. Each reference was live when checked; dates will be confirmed at clinical review.

1. National Institute for Health and Care Excellence. Fertility problems: assessment and treatment. NICE guideline CG156. Available from: https://www.nice.org.uk/guidance/cg156 [last checked 28 July 2026].
2. Royal College of Obstetricians and Gynaecologists. Diagnostic laparoscopy — consent advice. London: RCOG. Available from: https://www.rcog.org.uk/guidance/browse-all-guidance/consent-advice/ [last checked 28 July 2026].
3. National Health Service (UK). Laparoscopy (keyhole surgery). Available from: https://www.nhs.uk/conditions/laparoscopy/ [last checked 28 July 2026].

Patient information from our own clinics

1. Sugabi Clinic Ragama. Laparoscopy and dye test: checking the fallopian tubes. Available from: https://sugabi.lk/blog/1271/…
2. vog.lk — ලැපරොස්කොපි සැත්කම් සිදු කරන හැටි (Sinhala, by Dr Chaminda Mathota). Available from: https://vog.lk/735-laparoscopic_surgery.php