title: A technique for laparoscopic peritoneal entry after abdominoplasty.
abstract: OBJECTIVE
  The fascial anatomy of the anterior midline of the abdominal wall is permanently altered by the vertical plication of the rectus abdominis muscles commonly performed during abdominoplasty. In order to achieve safe and expeditious peritoneal entry in patients undergoing laparoscopy after a previous abdominoplasty, a modification of the standard midline open technique was developed. This not only facilitates entry and insufflation, but it also provides an acceptable cosmetic result following the laparoscopic surgery.
  
  
  METHODS
  A modified midline open Hasson technique of laparoscopic peritoneal entry that addresses the anatomical distortion created by a previous midline fascial plication was used in 24 consecutive patients undergoing elective laparoscopic cholecystectomy and is described herein.
  
  
  CONCLUSIONS
  This modified entry technique consistently allowed safe and expeditious peritoneal entry in 24 consecutive patients undergoing laparoscopic surgery after a previous abdominoplasty.
authors.affiliation: 1 Department of Surgery, Kaweah Delta Health Care District , Visalia, California.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cassaro
authors.forename: I Michael
authors.initials: IM
authors.lastname: Leitman
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D061645:Abdominoplasty / Q000379:methods*; D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery*; D017568:Rectus Abdominis / Q000601:surgery