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Through the use of echography after establishing the pneumoperitoneum, it is possible to recognize the presence of intra-abdominal adhesions and the distribution of gas. Using this method, the laparoscopist is able to form a picture of the intra-abdominal situation with regard to the site of the adhesions and the pneumoperitoneal chambers. This enables him to choose the best site for the insertion of the trocar both for the avoidance of possible incidents, and for optimal inspection. This method has been successfully employed in 39 patients with large abdominal surgical scars. Laparoscopy confirmed the echographic findings in almost all the cases. Thus, in 38% of cases the laparoscopic "inspection site" chosen was atypical with respect to the usual sites for the insertion of the laparoscope, but always proved to be the most suitable.

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The authors report their experiences with 1243 laparoscopic splenic biopsies performed between 1968 and 1982 at the Laparoscopy Center of the Regional Hospital in Padua. We may conclude that: The risk of laparoscopic splenic biopsy in minimal and fears regarding its performance are unjustified. The diagnostic value of splenic biopsy is evident if a comparison is made, in the different groups, between the percentage and the accuracy of the diagnoses made with the single macroscopic and the histological examinations, respectively. As well as the staging and follow-up of malignant lymphomas, examination of the spleen in clinically suspected splenopathy is a new and interesting indication for laparoscopy, for it is now possible to take one or more biopsies.

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