Abdominal reexploration may occasionally be necessary in cases of doub
tful bowel viability and intraabdominal sepsis. When this is indicated
, second-look laparoscopy may be a useful alternative to conventional
surgery, because it avoids subjecting an often critically ill patient
to the trauma and risks of relaparotomy. Performing the laparoscopy th
rough a cannula fitted to a flexible tube drain, inserted at the first
laparotomy or laparoscopy, is proposed. The drain is withdrawn slight
ly, a laparoscopic cannula is inserted into the drain, pneumoperitoneu
m is established, and the laparoscope is then passed down the cannula
and the drain for exploration, The authors considered this technique i
n 11 cases and report four cases in which it was used. Therapeutic lap
aroscopic procedures-e.g., drainage of collections, adhesiolysis, and
stroma formation-were carried out in two cases, and laparotomy was req
uired in two. This method is safe, atraumatic, and technically simple,
and it can serve diagnostic as well as therapeutic purposes. The simp
licity and ease of this method may encourage wider application to bene
fit more patients.