{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:08:09Z","timestamp":1785881289301,"version":"3.56.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n Systematic reduction of negative laparoscopy for pelvic pain is crucial to reducing surgical morbidity, improving diagnostic accuracy and minimising cost. This study aims to determine the incidence and consider the underlying causes of negative laparoscopy in women presenting with pelvic pain.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A 5\u2010year, retrospective cohort study was undertaken for women undergoing laparoscopy for pelvic pain. Patient selection was from an Australian tertiary public hospital with both non\u2010fellowship trained gynaecologists and an Australasian Gynaecological Endoscopic Surgery (AGES) accredited training programme (fellowship trained) as well as one private clinic comprising two fellowship trained gynaecologists. Data was collected from the medical records. A \u2018negative\u2019 laparoscopy was defined either visually or by vision and negative biopsy on histology. The rate of negative laparoscopy in the public and private sector was compared using an odds ratio.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 1309 women, 174 (13%) had a negative laparoscopy. The negative laparoscopy rate was significantly higher amongst non\u2010fellowship trained gynaecologists compared to those with fellowship training (OR\u2009=\u20092.48; 95% CI: 1.76\u20133.43,\n p<\/jats:italic>\n \u2009<\u20090.05). Visually negative laparoscopy was made in 48\/174 (28%) of cases, all from the public sector, with 41\/48 (85%) of laparoscopies without biopsy performed by non\u2010fellowship trained gynaecologists. A 56% discordance between intraoperative visualisation and histopathological findings was identified.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Overall, negative laparoscopy rates are low compared to previously reported data. The discrepancy between the healthcare sectors likely relates to patient factors, surgical training, and clinician bias. Peritoneal biopsy for symptomatic patients undergoing laparoscopy should be considered due to the potential to miss superficial disease.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ajo.70147","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T06:15:54Z","timestamp":1778307354000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Incidence of Negative Laparoscopy for Pelvic Pain Stratified by Level of Training and Location of Service Provision"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5738-3501","authenticated-orcid":false,"given":"Akshara","family":"Shyamsunder","sequence":"first","affiliation":[{"name":"Discipline of Women's Health, School of Clinical Medicine UNSW Sydney Sydney New South Wales Australia"},{"name":"Gynaecological Research and Clinical Evaluation (GRACE) Unit Royal Hospital for Women Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Ng","sequence":"additional","affiliation":[{"name":"Discipline of Women's Health, School of Clinical Medicine UNSW Sydney Sydney New South Wales Australia"},{"name":"Gynaecological Research and Clinical Evaluation (GRACE) Unit Royal Hospital for Women Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaynab","family":"El\u2010Hamawi","sequence":"additional","affiliation":[{"name":"Discipline of Women's Health, School of Clinical Medicine UNSW Sydney Sydney New South Wales Australia"},{"name":"Gynaecological Research and Clinical Evaluation (GRACE) Unit Royal Hospital for Women Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Krones","sequence":"additional","affiliation":[{"name":"Discipline of Women's Health, School of Clinical Medicine UNSW Sydney Sydney New South Wales Australia"},{"name":"Gynaecological Research and Clinical Evaluation (GRACE) Unit Royal Hospital for Women Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Nesbitt\u2010Hawes","sequence":"additional","affiliation":[{"name":"Discipline of Women's Health, School of Clinical Medicine UNSW Sydney Sydney New South Wales Australia"},{"name":"Gynaecological Research and Clinical Evaluation (GRACE) Unit Royal Hospital for Women Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Deans","sequence":"additional","affiliation":[{"name":"Discipline of Women's Health, School of Clinical Medicine UNSW Sydney Sydney New South Wales Australia"},{"name":"Gynaecological Research and Clinical Evaluation (GRACE) Unit Royal Hospital for Women Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Abbott","sequence":"additional","affiliation":[{"name":"Discipline of Women's Health, School of Clinical Medicine UNSW Sydney Sydney New South Wales Australia"},{"name":"Gynaecological Research and Clinical Evaluation (GRACE) Unit Royal Hospital for Women Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Jean Hailes \u201cThe Impact of Pelvic Pain is Vastly Underestimated \u201d [Online] (2025) accessed March 14 2025 https:\/\/www.jeanhailes.org.au\/news\/impact\u2010of\u2010pelvic\u2010pain\u2010vastly\u2010underestimated."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/beog.1999.0086"},{"key":"e_1_2_9_4_1","unstructured":"\u201cEndometriosis in Australia: Prevalence and Hospitalisations Summary \u2013 Australian Institute of Health and Welfare \u201d Endometriosis in Australia 2023 accessed October 22 2024 https:\/\/www.aihw.gov.au\/reports\/chronic\u2010disease\/endometriosis\u2010prevalence\u2010and\u2010hospitalisations\/summary."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16447"},{"key":"e_1_2_9_6_1","volume-title":"Endometriosis in Australia: Prevalence and Hospitalisations: In Focus","author":"Australian Institute of Health and Welfare","year":"2019"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223316"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac009"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13749"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/22840265251363707"},{"key":"e_1_2_9_11_1","volume-title":"Australian Clinical Practice Guideline for the Diagnosis and Management of Endometriosis","author":"RANZCOG","year":"2021"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2024.09.075"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13303"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2021.08.013"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2024.02.004"},{"key":"e_1_2_9_16_1","unstructured":"\u201cMedicare Benefits Schedule \u2013 Item 35637| Medicare Benefits Schedule \u201daccessed April 18 2025 https:\/\/www9.health.gov.au\/mbs\/fullDisplay.cfm?type=item&q=35637&qt=item."},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoab025"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.70147","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.70147","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.70147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:07:40Z","timestamp":1782274060000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.70147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,8]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/ajo.70147"],"URL":"https:\/\/doi.org\/10.1111\/ajo.70147","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,8]]},"assertion":[{"value":"2025-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70147"}}