[Visible control of peritoneal perforation in surgical pelviscopy]

From the inception of laparoscopy, the primary blind incision has presented an as yet unresolved risk. In "open laparoscopy", the abdomen is opened in the classic manner as though a "mini-laparotomy" were being performed. This is time-consuming, cosmetically unsatisfactory, and restricted locally. Using a newly tried-out technique, and adhering to the classic transumbilical Z-incision technique, both the muscle layer and the peritoneum beneath it are punctured under endoscopic sight. Here, the elliptically ground end of a trocar capsule slides along the epiperitoneum, until light shining through allows a growth-free site to be diagnosed. The preceding inflation of the pneuperitoneum is performed without risk by use of aspiration tests, vacuum tests, and sound tests, and simultaneous measurement of insufflation and static pressure (Semm monofil bivalent system).