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Case report: Combined hand access with laparoscopic pneumoperitoneum in intraperitoneal adhesiolysis


Previous abdominal surgery is one of the relative contraindications to safe induction of pneumoperitoneum with a Veress needle. Similarly visual inspection with a telescope may be limited and instrumental manipulation difficult. The manual ability to distract bowel loops and finger dissect greatly facilitates adhesiolysis and this is lost with conventional laparoscopy. A novel hand-access port is described which combines manual tactile ability with minimally invasive laparoscopic adhesiolysis.

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  1. 1.

    Lundoff, P., Hahlin, M., Kallfelt, B., Shortburn, J., Lindholm, B. Adhesion formation after laparoscopic surgery in tubal pregnancy: A randomised trial versus laparotomy. Fertil-Steril. 1991; 55(50): 911–5.

  2. 2.

    Gorey, T. R., O’Connell, P. R., Waldron, D., Cronin, K., Kerin, M., Fitzpatrick, J. M. Laparoscopically assisted reversal of Hartmanns Procedure. Brit. J. Surg. 1993; 80: 109.

  3. 3.

    Dunn, D. C. Digitally assisted laparoscopic surgery (letter). Br. J. Surg. 1994; 81: 474.

  4. 4.

    Alvarado, A. Manually assisted laparoscopic reversal of the Hartmann Procedure. Surgical Rounds, Aug. 1995; 317–21.

  5. 5.

    Gorey, T. F., Tierney, S., Buckley, D., O’Riordain, M., Fitzpatrick, J. M. Video-assisted Nissen’s fundoplication using a hand-access port. Min. Invs. Ther. & Allied Technol. 1996; 5: 364–6.

  6. 6.

    Gorey, T. R., O’Riordain, M. G., Buckley, D., Fitzpatrick, J. M. Laparoscopic-assisted rectopexy using a novel hand-access port. J. Laparoendoseopic-Surg. 1996; 6(5): 325–8.

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Correspondence to T. F. Gorey or S. Tierney or M. O’Riordain or D. Buckley or N. Gibbons or J. M. Fitzpatrick.

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Gorey, T.F., Tierney, S., O’Riordain, M. et al. Case report: Combined hand access with laparoscopic pneumoperitoneum in intraperitoneal adhesiolysis. I J M S 165, 297–298 (1996). https://doi.org/10.1007/BF02943096

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  • Intussusception
  • Veress Needle
  • Conventional Laparoscopy
  • Extensive Adhesion
  • Mater Hospital