ABSTRACT
The patient with previous abdominal surgery is at higher risk for visceral and vascular injuries during Veress needle and initial trocar insertion (1).
In the setting of previous surgery, an extraperitoneal/retroperitoneal approach can be undertaken. Urologic organs are well suited for this approach despite the more confined working space. Kidney, adrenal, ureteral, and prostate surgeries have all been described and successfully performed with the extraperitoneal approach. Alternatively, pneumoperitoneum can be created with a Veress needle that is inserted at least 3 cm away from previous abdominal incisions.
