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Peritoneal access and creation of pneumoperitoneum are the key initial steps of laparoscopic surgery. This is commonly achieved by either introducing Veress needle or by gradual dissection of all the layers of the abdominal wall and then introducing a port under direct vision. The two techniques are extremely safe, but large outcome studies have found slightly increased complications with the Veress needle. Randomized trials do not support such finding and both techniques continue to have their enthusiasts. We hereby describe an open method of initial port placement, wherein the port is introduced through the umbilical cicatrix under direct vision.

Open port placement through the umbilical cicatrix