The use of laparoscopy in gynecologic surgery has been well established to decrease morbidity, blood loss, hospital stay, and post-operative pain when compared to traditional open abdominal surgery. However, the laparoscopic technique is associated with post-operative shoulder pain.

We hypothesize that a combination of intraperitoneal saline lavage and active suction removal of carbon dioxide gas from the right upper quadrant of the abdomen will decrease incidence of post-laparoscopic shoulder pain when compared to passive exsufflation of carbon dioxide gas.

Inclusion Criteria:

• English speaking patient
• Female
• Age 18-75
• must undergo laparoscopic surgery
• willing to participate in the study

Exclusion Criteria:

• Male patients
• Under 18 or older than 75
• Laparoscopic procedures that get converted to laparotomy
• Intraoperative hemorrhage more than 500 cc
• Patients with active joint disease
• History of shoulder surgery
• Intraoperative laceration to the liver
• Malignancy
• Long term daily narcotic use
• Chronic right upper quadrant/ shoulder pain
• Pregnancy
• History of dementia, Alzheimers, stroke or other condition causing altered mental status