CASE-REPORT - COMBINED HAND ACCESS WITH LAPAROSCOPIC PNEUMOPERITONEUMIN INTRAPERITONEAL ADHESIOLYSIS

Previous abdominal surgery is one of the relative contraindications to safe induction of pneumoperitoneum with a Veress needle. Similarly vi sual inspection with a telescope may be limited and instrumental manip ulation difficult. The manual ability to distract bowel loops and fing er dissect greatly facilitates adhesiolysis and this is lost with conv entional laparoscopy. A novel hand-access port is described which comb ines manual tactile ability with minimally invasive laparoscopic adhes iolysis.