This paper examines the technique of directly inserting the laparoscopic trocar without establishing a previous pneumoperitoneum. The technique is carefully described, and a series of 1002 patients in whom it has been used are reported. The advantages of this method are discussed. Use of the Surgiport Disposable Trocar with the shield enhances the safety of this technique. This technique merits...

Veress needle insertion, direct trocar insertion and open technique are different methods of establishing pneumoperitoneum to perform a successful laparoscopic procedure. We conducted this study to compare the use of a Veress needle and direct trocar insertion to create pneumoperitoneum. 274 laparoscopic cholecystectomy operations were evaluated. There were no significant differences in the age...

A variety of surgical meshes are available to correct pelvic organ prolapse. This article discusses benefits and risks of vaginal mesh use. Emphasis is placed on the appropriate surgical technique to improve outcomes and minimize mesh complications. Placement options are reviewed with the discussion of self-tailored mesh, trocar-based mesh kits, and non-trocar mesh kits. This article also revie...

BACKGROUND Open appendectomy is still the most common method of treating appendicitis. Laparoscopic procedures for removal of the appendix by the "in" technique as an alternative to conventional appendectomy have gained wide popularity, but have been criticized for their technical difficulty and high cost. We assessed the safety and efficacy of the laparoscope-assisted appendectomy (the two-tro...

Laparoendoscopic single-site surgery (LESS) is a step toward the development of minimally invasive surgery. It is initially difficult for surgeons with limited experience to perform the surgery. We describe two cases of left adrenalectomy with a LESS combined with the addition of an accessory port. After a 2.5-cm skin incision was made at the level of the paraumbilicus to insert the primary 12-...

Figure 2 Glove stretched over the retractor, providing a seal Figure 3 Glove port with camera inserted removal (Fig 1). This technique can also be used at a stoma site. Once the specimen is removed, stretch a sterile size 61⁄2 glove over the retractor and re-establish pneumoperitoneum. A perfect seal will be obtained (Fig 2). If the port is still required, cut the tip off any finger of the glov...

Injuries associated with insufflation needles and trocar insertion have been reported extensively in the literature. Two millimeter laparoscopy is a more recent technique that has been used for laparoscopic cholecystectomy. This case illustrates a 2 mm trocar colonic injury, recognized during a routine laparoscopic cholecystectomy; management was non-operative and ambulatory, with a successful ...