Transumbilical open laparoscopy: a simple method of avoiding complications in pediatric surgery

The author reports his experience with a new procedure, transumbilical open laparoscopy (TUOL), to obtain the pneumoperitoneum in children operated upon laparoscopically. TUOL was designed to avoid complications related to closed introduction of the first trocar, and consists in the visually-guided introduction of the first trocar transumbilically without any need for a pursestring suture, with an operative time of about 1 min. The author recommends TUOL as it is easier, less expensive, and less time-consuming compared to other techniques.