1985 Volume 27 Issue 1 Pages 91-96_1
Out of 841 cases observed the liver with laparoscope in our department during 12 years from 1970 to 1981, forty eight cases had a history of laparotomy excluding appendectomy and repair of inguinal hernia. They had histories of upper abdominal surgery in 9 cases (group 1) and lower abdominal surgery in 39 cases (group 2). Laparoscopy failed to demonstrate the liver in one case in each group (11.1% in group 1, 2.6% in group 2, and 4.2% as a total). On the other hand, out of 793 cases without history of laparotomy, we failed to observe the liver in 5 cases (0.63%). Adhesion between abdominal organs and wall was observed in all cases with laparotomy and also found in 3 cases without laparotomy. There was no significant difference in occurrence of unobservable cases between operative and non-operative patients. Determining the proper location of trocar insertion (ie. far enough from the scar of laparotomy) after making adequate pneumoperitoneum, laparoscopy to the patients with a history of abdominal surgery will be performed safely.
