title: Direct insertion of the laparoscopic trocar after an earlier laparotomy.
abstract: Direct insertion of the laparoscopic trocar without the aid of a prior pneumoperitoneum has been described previously. Prior laparotomy has been cited as a contraindication to this technique. At our free-standing ambulatory surgical unit, 1,670 consecutive laparoscopies utilizing direct insertion of the trocar were performed during a four-year period. Four hundred sixteen women had had previous abdominal surgery. One bowel injury occurred in this group. A patient without prior surgery sustained an intraabdominal laceration requiring further surgery and hospitalization. Based on this experience, we do not find previous abdominal surgery to be a contraindication to the use of direct insertion of the laparoscopic trocar.
authors.affiliation: Women's Medical Pavilion, Dobbs Ferry, New York.
authors.forename: S G
authors.initials: SG
authors.lastname: Kaali
authors.forename: G
authors.initials: G
authors.lastname: Bartfai
mesh_terms: D000005:Abdomen / Q000601:surgery; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D013246:Sterilization, Tubal / Q000379:methods