ABSTRACT

Figure 11.2. Inferior epigastric vessels. After the introduction of the laparoscope, accessory trocars must be placed. The placement of the lateral accessory trocars is crucial, since improper placement can make the procedure difficult. Given that the staging procedure requires access to both the abdomen and the pelvis, accessory trocars are usually placed lateral to the inferior epigastric vessels and rectus muscles. These vessels should be visualized before introduction of the lateral trocars. Visualization of the inferior epigastric vessels can be aided by simple external pressure applied in the inguinal region. This distends the vessels and aids in their identification.