The founders of the endoscopic method for examining the female pelvic organs can be considered the Russian obstetrician-gynecologist D. O. Ott (1901) and the German scientist G. Kalling (Applied Anatomy). The pelvic organs—the bladder and urethra, the uterus and vagina, and the rectum—are closely adjacent to one another. The uterus and its appendages occupy a central position, protruding into the pelvic cavity more than other organs and forming two recesses: the anterior—uterovesical—and the posterior—uterorectal—which is deeper than the anterior. This recess contains a space through which the abdominal cavity can be easily accessed from the outside. This space is the posterior vaginal fornix, represented by a thin septum composed of mucous, muscular, and peritoneal (serous) layers. The vagina is cylindrical in shape and is 8-10 cm long. In its upper part, it passes into the cervix and forms a vault. The length of the cervix is ??up to 3 cm. In its center, there is an opening of the cervical canal, limited by the anterior and posterior lips of the cervix. The cervical canal passes into the uterine cavity, which has a triangular shape. In its upper sections, there are pinpoint openings leading to the tubal canals. The protruding uterus is tilted anteriorly. To the sides of it, in broad ligaments, the fallopian tubes extend, the distal ends of which are expanded and have bright pink fringes. Behind, on the broad ligaments, are the ovaries, which have a whitish color. Round ligaments extend from the anterior wall of the uterus, going to the pubis in the anterior abdominal wall. Indications and contraindications. Planned diagnostic and therapeutic studies are performed if tumors of the internal genital organs are suspected; infertility and the need to determine the patency of the fallopian tubes as its cause; in case of developmental anomalies of the internal genital organs; presence of persistent pelvic pain; in case of necessity to control performance of diagnostic and therapeutic interventions using other methods (for example, bougienage of fallopian tubes during hysteroscopy); in case of necessity to perform biopsy in patients with various pathologies requiring morphological verification. Indications for emergency diagnostic and therapeutic laparoscopy (culdoscopy): 1) differential diagnostics of acute surgical and gynecological diseases; 2) inability to exclude acute surgical diseases in the presence of clinical picture of gynecological diseases; 3) bleeding into the abdominal cavity; 4) progressive and disrupted ectopic pregnancy; 5) uterine damage and incomplete ruptures during childbirth; 6) performing therapeutic operations. Contraindications to laparoscopy (culdoscopy) include: general contraindications: decompensated pulmonary heart failure, acute infectious diseases (influenza, tonsillitis), acute hepatitis, decompensated diabetes mellitus, and hemorrhagic diathesis; local contraindications: adhesions, inflammatory and other skin lesions, and hernias. Culdoscopy. Culdoscopy (douglasoscopy, transvaginal laparoscopy) is an endoscopic examination of a woman's internal reproductive organs, performed by inserting an endoscope into the rectouterine pouch of the abdominal cavity through the posterior vaginal fornix. To perform culdoscopy, the following are required: a power source, light guides, optical tubes [https://eleps.ru/katalog/gisterorezektoskopiya-i-ginekologiya-optika-gisteroskopy/] with a lateral view (90–135°), and a trocar—the same set that can be used for laparoscopy and thoracoscopy. In addition, gynecological instruments are used: forceps, a vaginal speculum, an elevator, bullet forceps, a syringe with a long anesthetic needle, needles for puncturing the posterior vaginal fornix, a narrow scalpel, syringes, a needle holder with a needle, and suture material. Culdoscopy is a surgical procedure with its attendant principles of preparation. The examination is performed on an empty stomach after thorough bowel preparation with cleansing enemas and emptying the bladder. The pubic and perineal hair is shaved, and the vagina is irrigated with a 0.02% furacilin solution. Sedatives and anesthetics are administered 30–45 minutes before the examination. Culdoscopy is performed in a small operating room on a gynecological chair. In a typical position, after cleaning the vagina with an iodine solution and alcohol, paracervical anesthesia is administered with 0.5% novocaine solution, and the patient is placed in the knee-chest position. The back of the chair is lowered. The patient kneels, rests her head, forearms, and elbows on a soft pillow, arches her back as much as possible, and lifts her pelvis. In this position, the intestinal loops descend, emptying the pelvic cavity. Using a grooved speculum and a lifter, the cervix is ??exposed, the posterior lip is grasped with bullet tips, and retracted. The posterior fornix is ??punctured with a thick needle. Air hisses into the abdominal cavity, creating pneumoperitoneum. A narrow scalpel is used to make an incision through the posterior fornix, and a trocar and endoscope are inserted. During examination of the pelvic organs, the posterior surface of the uterus, fallopian tubes, and ovaries are usually clearly visible. If this is difficult, the field of view can be increased by inserting a pertubation tip or a hollow uterine probe into the cervical canal and repositioning the uterus. After the examination is complete, the endoscope is removed. To evacuate all air, the patient takes a deep breath and strains. Once the air has been expelled through the trocar tube, it is removed, and the colpotomy opening is sutured. The patient is transferred to a normal position on a chair and then to the ward. Bed rest is required for 24 hours.