A new portal for gynecologic laparoscopy

We used the middle upper abdomen as a primary port insertion as an alternat ive portal for laparoscopy and multiport operative pelviscopy in 188 women who were at high risk for subumbilical adhesions because of previous abdomi nal surgeries or history of gynecologic cancer. Primary cannula insertion w as in the middle upper abdomen between xyphoid process and umbilicus (Lee-H uang point). This was the single entry site for the Veress needle and prima ry laparoscopy port. In 184 (98.4%) of 188 women surgery was performed with out complications. No procedure was converted to laparotomy due to visceral or vascular injuries. Two omentum injuries from primary port insertion wer e repaired with bipolar electrocoagulation; a colon injury was repaired wit h laparoscopic sutures. In our experience, this laparoscopic port is effect ive in women who have had abdominal surgery or gynecologic malignancy.