With diagnostic or exploratory laparoscopy a direct inspection of intraabdominal organs is possible. The closed laparoscopic entry with the use of a Veress needle for insufflation followed by the blind insertion of a trocar is the most common approach used by gynecologists worldwide. All secondary ports should be introduced under vision. The trocar placement depends on surgical indications, organ pathology, adhesions and adipose tissue distribution. The first step is to rule out any injuries that might have been caused by the Veress needle or by the blind insertion of the first trocar. After that the laparoscope can be turned and all abdominal organs can be displayed.
At the end of every laparoscopic surgery the most common complications of laparoscopic surgery should be checked and ruled out. In case of minimal bleeding close to the rectum or the ureter the use of topical haemostatic agents can be considered.
Veress needle Palmer’s Point Port placement Thermal injuries Haemostatic agents
This is a preview of subscription content, log in to check access.
Ahmad G, O’Flynn H, Duffy JM, Phillips K, Watson A. Laparoscopic entry techniques. Cochrane Database Syst Rev. 2012;2:CD006583.Google Scholar
Pierre F, Chapron C. Complications of laparoscopy: an inquiry about closed versus open-entry technique. Am J Obstet Gynecol. 2005;192(4):1352–3.CrossRefPubMedGoogle Scholar
Jansen FW, Kolkman W, Bakkum EA, de Kroon CD, Trimbos-Kemper TC, Trimbos JB. Complications of laparoscopy: an inquiry about closed- versus open-entry technique. Am J Obstet Gynecol. 2004;190(3):634–8.CrossRefPubMedGoogle Scholar
Agarwala N, Liu CY. Safe entry techniques during laparoscopy: left upper quadrant entry using the ninth intercostal space–a review of 918 procedures. J Minim Invasive Gynecol. 2005;12(1):55–61.CrossRefPubMedGoogle Scholar