Trocar Placement

We use a W-shaped arrangement of the trocars with insertion of the first trocar (12 mm) periumbilical minilaparotomy (Hasson technique). This port is used for the laparoscope and later for retrieving of the specimen. The other four trocars (2 X 10 and 2 X 5 mm) are placed under endoscopic control after establishing the pneumoperitoneum (maximum pressure 15mmHg, maximum flow 30 mL). The abdomen is inspected for trocar injury, bleeding, and adhesions. Anatomic landmarks to observe are the Foley balloon in the bladder, obliterated urachus (median umbilical ligament) in the mid-line, the two obliterated umbilical ligaments (medial umbilical ligament), and the vasa deferentia.

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