Two small retractors are introduced to prevent the abdominal wall from collapsing once the peritoneum is entered. The laparofan is now introduced and hooked up to the laparolift system. Adequate elevation of the abdominal wall is achieved. The patient is put in steep Trendelenburg position. This incision is approximately 2.5 cm long.
Care is taken to avoid the epigastric artery and vein.
A sponge stick is inserted under the laparofan in the same incision in the left lower quadrant. This type of instrument has a long fulcrum and the tip therefore can be opened intraabdominally without a problem through a small incision. The rectum is grasped and pulled to the left by the assistant. The surgeon now introduces a laparoscopic fenestrated forceps and the coagulating hook, both through the right lower quadrant incision. The right parietal peritoneum lateral to the rectum is incised.