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Although studies have suggested that the open technique of initial trocar placement may be associated with a lower incidence of major vascular injuries, the same cannot be said for visceral injuries [14]. The incidence of this complication is about 0.05% of all open access procedures [19]. The main difference between bowel injuries occurring during the open technique compared with the closed technique is that with the open procedure, it is more likely that the injury will be immediately obvious and repaired without delay. Veress needle injuries to the large and small bowel may be associated with a higher incidence of peritonitis and other complications than injuries to the stomach, which can often be managed conservatively.

ssss1 Principal function of many port closure devices (PCD) include a needlescopic grasper, which does not require a cannula. (A). From left to right: PCD in neutral position‐grasper contained within the needle lumen, PCD with top button engaged which exposes the grasper, PCD grasps suture material, PCD with suture ready to be introduced. (B) PCD and suture is introduced under visual guidance next to the cannula. (C). With suture released within the body cavity the PCD is now introduced on the opposite side of the cannula to grasp the suture end. (D). Both suture ends are now exteriorized and can be tied to close the port site.