title: Case report: combined hand access with laparoscopic pneumoperitoneum in intraperitoneal adhesiolysis.
abstract: 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.
authors.affiliation: Mater Hospital, Dublin.
authors.forename: T F
authors.initials: TF
authors.lastname: Gorey
authors.forename: S
authors.initials: S
authors.lastname: Tierney
authors.forename: M
authors.initials: M
authors.lastname: O'Riordain
authors.forename: D
authors.initials: D
authors.lastname: Buckley
authors.forename: N
authors.initials: N
authors.lastname: Gibbons
authors.forename: J M
authors.initials: JM
authors.lastname: Fitzpatrick
mesh_terms: D000368:Aged; D005260:Female; D006225:Hand; D006801:Humans; D010535:Laparoscopy; D010532:Peritoneal Diseases / Q000601:surgery*; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D000267:Tissue Adhesions / Q000601:surgery