title: Safe introduction of ancillary trocars.
abstract: The problem of laparoscopic entry is currently still unsolved, and despite the various techniques adopted by the surgical community, it has not yet been determined which is the correct access in all patients. Add to this the problem of safe ancillary port introduction; all surgeons must avoid vascular and visceral damage. The 2 most common problems with second port trocars are inferior and superior epigastric artery damage, and bowel loops and adhesions. Over the years, we have developed 2 steps that are very useful to avoid iatrogenic injuries to vessels and viscera. In this brief report, we explain the following 2 simple steps, called by the authors "yellow island" port entry and second trocar "tip entry guided" by a suction cannula. In our practice of more than 3400 conventional laparoscopies, with data from patients with different characteristics, surgeons who have introduced laparoscopic surgery into their daily practice might teach these steps to young fellows and trainees.
authors.affiliation: Department of Obstetrics & Gynecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Tinelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Gasbarro
authors.forename: Pietro
authors.initials: P
authors.lastname: Lupo
authors.forename: Antonio
authors.initials: A
authors.lastname: Malvasi
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Tsin
authors.forename: Fausto
authors.initials: F
authors.lastname: Davila
authors.forename: Guillermo
authors.initials: G
authors.lastname: Dominguez
authors.forename: Liselotte
authors.initials: L
authors.lastname: Mettler
authors.forename: Paul Alan
authors.initials: PA
authors.lastname: Wetter
mesh_terms: D019074:Epigastric Arteries / Q000293:injuries; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods*; D013525:Surgical Instruments; D014172:Transillumination; D014781:Viscera / Q000293:injuries