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Avoiding adherent bowel injury & adhesiolysis

in laparoscopy.

Avoid adherent bowel injury

Pfannenstiel incision

Veress needle at Palmer's point i.e.

For first blind port use Jain's point

All other ports under scope vision.

See first port entry point from 2nd port.

shift to another port

Could work around the adhesions easily

Adhesiolysis increases operating time

Can cause iatrogenic injury

Neo-bowel adhesions

adhesiolysis may result in obstructive symptoms