Access to the Abdomen

  • Daniel M. Hallam
  • Muzaffar A. Anwar
  • Iflikhar M. Khan
  • Muhammed Ashraf Memon
  • Kimberly Steele
  • Anne Lidor
  • Daniel M. Hallam

Initial access to the abdomen may be achieved percutaneously with a Veress needle (closed technique), or by a small cutdown and direct placement of a blunt-tipped Hassan cannula into the peritoneum under visual control (open technique). A variety of optical access trocars are also available, but most are used after pneumoperitoneum is first established percutaneously. Laparoscopic surgeons need to be facile in both the open and closed techniques, but most have a strong preference for one or the other method and will use that method preferentially, modifying the technique if unusual circumstances exist. This chapter uses the case of a healthy young woman with no previous abdominal surgery to explore these choices and preferences. Both techniques are thoroughly described in the SAGES manuals.


Rectus Sheath Bowel Injury Closed Technique Previous Abdominal Surgery Veress Needle 
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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Daniel M. Hallam
    • 1
  • Muzaffar A. Anwar
    • 2
  • Iflikhar M. Khan
    • 3
  • Muhammed Ashraf Memon
    • 4
    • 5
    • 6
  • Kimberly Steele
    • 7
  • Anne Lidor
    • 8
  • Daniel M. Hallam
    • 1
  1. 1.Department of SurgeryUniversity of Iowa Hospitals and ClinicsIowa CityUSA
  2. 2.Whiston HospitalPrescotUK
  3. 3.Department of Surgery/Liver TransplantMount Sinai Medical CenterNew YorkUSA
  4. 4.Department of SurgeryIpswich HospitalAustralia
  5. 5.Department of SurgeryThe University of QueenslandHerstonAustralia
  6. 6.Faculty of Health Sciences and MedicineBond UniversityGold CoastAustralia
  7. 7.Department of SurgeryThe Johns Hopkins Medical InstitutionsBaltimoreUSA
  8. 8.Johns Hopkins Center for Bariatric Surgery, Johns Hopkins Bayview Medical CenterBaltimoreUSA

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