Alternative Site Entry for Laparoscopy in Patients with Previous Abdominal Surgery

Laparoscopic procedures are increasingly performed in patients who have undergone prior abdominal surgery. Safe entry into the peritoneum includes avoidance of underlying viscera often tethered to the abdominal wall from surgical adhesions. Our group describes an alternative site technique utilizing the open Hasson procedure in a previously unoperated field, thus avoiding potential underlying adhesions. During the past 24 months this technique has been performed successfully in 95 patients, and no open conversions due to visceral or vascular injuries were necessary. Previous abdominal surgery should not be an absolute contraindication to minimally invasive procedures.