既往手术史或复杂路径患者的腹腔镜检查

                               
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In this video, we review entry techniques, and suggest a novel entry point, in patients with previous surgical history. Palmer's point is the traditional point of entry in patients in whom adhesions is suspected.
However, palmers point is associated with disadvantages including limited use if there is a history of left upper quadrant surgery and possible injury to liver or stomach even with proper precautions. Guan's Point is a novel location for laparoscopic entry that you can be used in any situation you would normally consider Palmer's Point. Guan's point is ideally placed for continued use as the camera port after placement and avoids possibility of liver and stomach injury. Finally, we suggest liberal use of preoperative and intraoperative imaging to assist in laparoscopic entry in patients with extensive surgical history.

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