Prelaparoscopic echography used to detect abdominal adhesions.

Through the use of echography after establishing the pneumoperitoneum, it is possible to recognize the presence of intra-abdominal adhesions and the distribution of gas. Using this method, the laparoscopist is able to form a picture of the intra-abdominal situation with regard to the site of the adhesions and the pneumoperitoneal chambers. This enables him to choose the best site for the insertion of the trocar both for the avoidance of possible incidents, and for optimal inspection. This method has been successfully employed in 39 patients with large abdominal surgical scars. Laparoscopy confirmed the echographic findings in almost all the cases. Thus, in 38% of cases the laparoscopic "inspection site" chosen was atypical with respect to the usual sites for the insertion of the laparoscope, but always proved to be the most suitable.