[Failures and hazards of surgical laparoscopy]

During the filling up of the pneumoperitoneum the needle can be put in the wrong direction and so blood vessels , intestinum or adhesions might be punctured. According to the authors procedure the abdominal wall is grasped by one hand or an instrument. This way the umbilicus is placed in the best position for the puncture with the Verresneedle or the trocar. Pulling with the left hand vertically the direction of the needle or trocar consequently will be parallel to the vertebral column. With this procedure, lesions of intestinum or vessels are practically impossible. In more than 4000 personally performed laparoscopies the author never saw adhesions in the region of the umbilicus except in two cases of cancer patients. If the intestinum is adherent to the umbilicus, as in the case of ileus, surgical measures are necessary.