the medical literature is replete with articles verifying the usefulness of laparoscopic procedures under local anesthesia . recent research has examined the efficacy of microendoscopy with local anesthesia . in this series of patients , we focused on new technology to determine if microendoscopy could be utilized in an office setting . between july 1994 and april 1995 , we performed 51 microendoscopic office laparoscopy under local anesthesia ( micro - olula ) using the 1.5 mm pixie laparoscope by origin , a 1.7 mm laparoscope by optimed and 5 mm laparoscope by jarit . all cases were performed in an office operating room at the women 's medical plaza in montgomery , alabama . only one patient was unable to have the procedure completed due to intolerance under local anesthesia . fifty - one micro - olulas were performed on these patients who had an average age of 31 years and an average weight of 157 pounds . one case was done with a 5 mm laparoscope and five cases with the 1.7 mm optimed laparoscope . our patients seemed to like the idea of a small device to view their pelvic cavities . the small laparoscopes provide excellent cosmesis , and laparoscopes deserve further development and clinical trial to determine their most advantageous use in the office setting . the medical literature is replete with articles verifying the usefulness of laparoscopic procedures under local anesthesia . recent research has examined the efficacy of microendoscopy with local anesthesia . in this series of patients , we focused on new technology to determine if microendoscopy could be utilized in an office setting and to evaluate the patient 's pain responses to various aspects of micro - olula . between july 1994 and april 1995 , we performed 51 microendoscopic office laparoscopy under local anesthesia ( micro - olula ) using the 1.5 mm pixie laparoscope by origin , a 1.7 mm laparoscope by optimed and 5 mm laparoscope by jarit . all cases were performed in an office operating room at the women 's medical plaza in montgomery , alabama . in a previous publication , only one patient was unable to have the procedure completed due to intolerance under local anesthesia . all patients were evaluated preoperatively with a complete history and physical exam , viewed a video on laparoscopy under local anesthesia and given the belly test . basic operative technique was similar to our previously published office laparoscopy cases : i.e. , intramuscular preop meds , field block anesthesia at the umbilicus and a paracervical block . fifty - one micro - olulas were performed on these patients who had an average age of 31 years and an average weight of 157 pounds . one case was done with a 5 mm laparoscope and five cases with the 1.7 mm optimed laparoscope . we obtained pain data in 29 patients using the pain survey by fishburne from an earlier paper . similar to fishburne 's original work , we evaluated our patient 's pain response to six parts of the procedure using a scale from 0 to 4 ( 0 = no pain , 1 = slight pain , 2 = moderate pain , 3 = severe pain , 4 = extremely severe pain ) . for this study we evaluated the patient 's response to the paracervical block , skin evaluation , co2 gas insufflation , trocar insertion , uterine motion and fallopian tube pain ( table 2 ) . most of the surveyed patients had minimal postoperative complaints of nausea , vomiting , syncope and other difficulties ( table 3 ) . only two patients of this series said that they would not recommend micro - olula to a friend . the remainder of the patients said that they would highly recommend micro - olula to their friends . fishburne 's pain survey suggested that the most painful aspect of micro - olula was movement of the uterus . it is possible , however , that painful uterine motion may be related to anxiety or pelvic pathology . from our small series of patients it appears that the pain associated with micro - olula is minimal . from our initial experiences with microendoscopes , we believe that clinicians can readily utilize diagnostic laparoscopy in an office setting . in the near future , we plan to do more micro - olula with two punctures to assess pelvic pain patients , adhesiolysis and patients needing assisted reproductive technology ( art ) . ultimately , micro - olula technique may permit us to evaluate pelvic pain patients in the office with little preparation of the patient . we do not believe that patient safety is compromised by using a no iv technique since we had ivs available in the office operating room and had extensive experience in performing office laparoscopy . the no iv technique is not recommended for those beginning their experience with office laparoscopy . there are disadvantages associated with micro - olulas including a small field of view and decreased magnification with small laparoscopes . the pixie laparoscope has potential for use in an office setting but may be limited due to cost concerns . our patients seemed to like the idea of a small device to view their pelvic cavities . microendoscopes deserve further development and clinical trials , to determine their most advantageous use in the office setting .