title: The minilaparoscope as a tool for localization and preparation for cannula insertion in patients with multiple previous abdominal incisions or umbilical hernia.
abstract: OBJECTIVE
  To access a method that attempts to reduce the risk of bowel and blood vessel trauma in entry-risk patients during laparoscopy.
  
  
  METHODS
  Three-year observational study (Canadian Task Force classification II-2).
  
  
  METHODS
  Tertiary university hospital.
  
  
  METHODS
  Thirty-one women defined as entry-risk due to previous multiple abdominal surgeries or repair of umbilical hernia.
  
  
  METHODS
  Laparoscopy performed with a 2 mm minilaparoscope inserted at Palmer's point, a midclavicular position under the lower left rib.
  
  
  RESULTS
  In most cases the minilaparoscope was used to inspect the anterior abdominal wall for adhesions. When a location free from adhesions was seen or created by adhesiolysis, the 5- or 10-mm cannula was inserted, followed by the laparoscope. Periumbilical adhesions were more common after previous longitudinal incisions. There were no complications.
  
  
  CONCLUSIONS
  Minilaparoscopy is safe and effective for identifying and preparing a proper cannula insertion point. This may be useful for avoiding bowel or other cannula-related trauma in women at high risk for such a complication.
authors.affiliation: Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon 58100, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Golan
authors.forename: R
authors.initials: R
authors.lastname: Sagiv
authors.forename: A
authors.initials: A
authors.lastname: Debby
authors.forename: M
authors.initials: M
authors.lastname: Glezerman
mesh_terms: D000005:Abdomen / Q000601:surgery*; D034861:Abdominal Wall / Q000503:physiopathology; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D015331:Cohort Studies; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000706:statistics & numerical data*; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery