First trocar entery in laparoscopic bariatric surgery; technical pearls and tricks

Laparoscopy begins with the safe creation of a pneumoperitoneum, often a difficult step in the bariatric patient. To minimize entry-related injuries, several techniques, instruments and approaches have been introduced during the last years. First Trocar insertion related Complications can occur even in the best of hands and it is vital that these are recognized promptly and immediately addressed. In our experience we use some steps in trocar entry to minimize trocar related abdominal injuries.