A modified laparoscopic entry technique using a finger.

In an effort to reduce the complication rate at laparoscopy, especially in patients who have previously undergone laparotomy, the so-called open laparoscopy technique was developed by Hasson and Grimes. Both investigators use minilaparotomy to enter the abdominal cavity. Hasson has developed a special laparoscopic instrument, whereas Grimes uses conventional instrumentation. For 1 year the authors have been using an extremely simple and safe method in performing laparoscopy: After incision of the skin and fascia infraumbilically, the index finger is introduced through these incisions, and the preperitoneal fat and the peritoneum are perforated with the finger, which is also used to explore the area around the incision for adhesions. After insufflation of CO2 through the sleeve, the optics are introduced in the usual manner.