An improved method of securing abdominal wall bleeders during laparoscopy.

INTRODUCTION LAPAROSCOPY AND OPERATIVE LAPAROSCOPY are the second most commonly performed gynecologic procedures after dilatation and curettage. During these procedures, injuries to the blood vessels in the abdominal wall have resulted from direct trauma caused by either the pneumoperitoneum needle or the trocars. (1) An injury can occur despite direct visualization, elevation of the abdominal wall, and establishment of a large pneumoperitoneum. (2,3) Such injuries have been reported as caused by the pneumoperitoneum needle in 31 of 109 cases, a primary trocar in 28 of 104 cases, and a secondary trocar in 28 of 61 cases. (3) The incidence of injuries to the inferior epigastric vessel is not generally known.