Laparoscopy: direct trocar insertion without pneumoperitoneum.

This paper examines the technique of directly inserting the laparoscopic trocar without establishing a previous pneumoperitoneum. The technique is carefully described, and a series of 1002 patients in whom it has been used are reported. The advantages of this method are discussed. Use of the Surgiport Disposable Trocar with the shield enhances the safety of this technique. This technique merits further investigation as an easy and safer means of performing laparoscopy.