title: A technique for open trocar placement in laparoscopic surgery using the umbilical cicatrix tube.
abstract: BACKGROUND
  Increasingly the open method for placement of the initial or first trocar is replacing the conventional technique with the Veress needle. Indeed, it is preferred because it affords peritoneal access under direct vision. A number of methods have been described in the literature using a variety of approaches and different instruments.
  
  
  METHODS
  We describe a method of open trocar placement in the supra- or subumbilical region that follows a stepwise procedure and employs specific instruments sequentially, while utilizing the umbilical cicatrix pillar or tube.
  
  
  RESULTS
  This technique has been done in 525 cases with no complications or port site hernias.
  
  
  CONCLUSIONS
  This is a simple technique that is safe and easy to learn. It can be performed rapidly and is a reliable method for the insertion of the first port under vision.
authors.affiliation: Department of Surgery, Maulana Azad Medical College and Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, PIN 110002, India. drplal@yahoo.com
authors.forename: Pawanindra
authors.initials: P
authors.lastname: Lal
authors.forename: R
authors.initials: R
authors.lastname: Sharma
authors.forename: R
authors.initials: R
authors.lastname: Chander
authors.forename: V K
authors.initials: VK
authors.lastname: Ramteke
mesh_terms: D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D002921:Cicatrix / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D010529:Peritoneal Cavity / Q000601:surgery; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors; D014472:Umbilicus / Q000601:surgery*