The only way to diagnose endometriosis is by a laparoscopy. This is a minor operation in which a telescope (a laparascope) is inserted into the pelvis via a small cut near the navel. This allows the surgeon to see the pelvic organs and any endometrial implants and cysts. Occasionally diagnosis is made during a laparotomy. A laparotomy is a major operation, which involves a cut into the abdomen. Ultrasound scans, blood tests and internal examinations are not a conclusive way to diagnose endometriosis.