An alternative technique for open laparoscopy.

Laparoscopic cholecystectomy has become a routine surgical procedure. Complications related to use of the laparoscope frequently result from insertion of a Veress needle or blind introduction of the primary cannula on its trocar. This risk is clearly higher in patients who have undergone previous surgical operations. Open insertion with visualisation of abdominal cavity before the introduction of the primary cannula reduces the risk of major vascular and visceral injury. Nevertheless, open laparoscopy has rarely been adopted mainly due to gas leak from the wound and because it is time-consuming. A simple, quick and effective technique is described. The authors experience with this technique in the last 500 cases has shown that it has no effect on the duration of operation, and does not involve a larger skin incision. This technique has been associated with no operative difficulty.