Following the routine use of the diagnostic-operative laparoscopy in the surgical diagnosis and therapy of the lower abdominal pain, the surgeon is confronted with a plethora of gynecological diseases. Due to the unknown appearance, suboptimal therapy follows. Intra-operative consultation of a gynecologist does not necessarily bring the expected solution as there is a lack of gynecological anamnesis and preoperative examination. To avoid insufficient endosurgical diagnosis, therapeutical failures and iatrogenic infertility, the gynecological diagnosis scheme with subsequent therapy is described. Completing the preoperative diagnostics by a gynecological investigation can improve endosurgical treatment and avoid second-look surgery.