Second-look laparoscopy for visceral ischemia facilitated by preinstalled ports

Much of the information of a second-look laparotomy can be obtained by a second-look laparoscopy. We describe the strategy and technique of installing laparoscopy ports at the end of the primary laparotomy for visceral ischemia to facilitate a second-look laparoscopy in the ensuing 72 hours. The advantages and limitations are illustrated by three cases. The primary advantage appears to be that when second-look laparoscopy can be accomplished at a minimal cost, much of the inhibition to use it is removed. However, more experience is necessary before the procedure can be used to replace laparotomy.