The procedure starts with a minilaparotomy for the camera trocar (T1, 10mm) about 3cm cephalad of the navel. After inserting the trocar, establish pressure-controlled pneumoperitoneum up to 13mm Hg and inspect the abdominal cavity for possible adhesions (e.g., after abdominal hysterectomy via Pfannenstiel incision). Successively introduce the working trocars under laparoscopic view: T2 (5mm) right lower quadrant at the level of the anterior superior iliac spine, T3 (10mm) roughly centered on a slightly curved line connecting T1 and T2. Finally insert T4 (5mm) in the left lower quadrant suprasymphyseally in the course of the subsequent Pfannenstiel incision.
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Pneumoperitoneum and trocar positioning
![Pneumoperitoneum and trocar positioning]()
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Opening the right pelvic peritoneum
Tilt the operating table to Trendelenburg, and with two atraumatic grasping forceps pull the greate
Tilt the operating table to Trendelenburg, and with two atraumatic grasping forceps pull the greate
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