Visually controlled trocar insertion by means of the "optical scalpel".

The importance of a safer approach to the abdominal cavity has led to several developments in the field of trocars, cannulae and puncture techniques. Examples are the insertion of a needle scope into a Veress needle, complex access cannulae and our new principle of using an "optical scalpel". In our view, direct optical visualization and actively controllable penetration of the abdominal wall are mandatory. First experimental and clinical applications indicate the newly developed "optical scalpel" (Olympus Winter & Ibe, Hamburg, Germany) as a reliable and useful instrument for a safe approach to the endoscopic operative field. This instrument was successfully used in 10 endoscopic operations and is currently undergoing further clinical testing.