Management of 188 consecutive abdominal surgical incisions in cancer patients following special techniques during the past ten years was evaluated. Closure of the surgical incisions was carried out employing interrupted wire for fascia and running wire for the approximation of subcutaneous tissue and skin. Prophylactic antibiotics were routinely administered to patients by the intravenous route as an adjunct to minimize infection including wound complications. Normal healing of surgical incisions was recorded in all instances during the present evaluation.

ferred from there to me. My assistant, Dr. Heckmann, diag¬ nosticated a slight bulging of the right side of the neck and a corresponding osseous tumor which could be traced from the spinal column to the neighborhood of the sternoclavicular joint. Pulsation was marked. After Dr. Heckmann had con¬ firmed his diagnosis of accessory cervical rib by means of the Roentgen plate ( Fig. 1 )

A variant of the technique of open laparoscopy is reported. The principal feature of this technique is that creation of a pneumoperitoneum is simplified. No additional instruments are required, nor sharp instruments, except for the skin incision and splitting of the fascia. The modified open laparoscopy technique was used on 23 high-risk patients in a group of 224 patients on whom laparoscopy was performed at Ludwigshafen Gynecological Clinic. The technique is discussed with reference to the literature.