Speculum placed in vagina. Cervix visualized and grasped. An Endometrial curettage was performed using Explora curette. Uterus was sounded to approx. 9 cm. The hysteroscope was placed. Uterine seal could not be obtained for endo. ablation. Scope removed. Zumi manipulator was placed. Tenaculum was removed, speculum was removed. Infraumbilical skin incision was made with outside knife. Veress needle placed and 10mm step trocar placed. Operative scope was put to approx. 2 liters of CO2 gas allowed to inflate. Pelvis was inspected. Dark peritoneal implants noted throughout the pelvis. Uterus was noted to be scarred posteriorly with tubes and ovaries scarred. Ovaries were barely visualized secondary to scarring with dark powder burn areas. Two biopsies were obtained using blunt grasper. Hemostasis achieved using cautery. Given this, the tube was scarred down and difficult to reach secondary to Ext. adhesive disease, it was decided not to proceed with tubal ligation. Peritoneal washings fluid was obtained for cell block and cytology.