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ssss1 Transabdominal needle introduction. The needle is ideally introduced such that the needle holder (not visible in field) can grasp it without needing repositioning. An ideal introduction is noted here as the light reflects off the entire curvature of the needle. This is a cue for perpendicular orientation toward the right‐hand needle driver.

ssss1 Needle introduction through cannula site. (A) The cannula is removed, (B) threaded onto the instrument. The suture material is grasped 2–3 cm from the needle, and (C) introduced through the cannula site. The cannula is replaced.

If transabdominal introduction is prohibited by suture type or by animal size, as in most large animals, the needle and suture often need to be passed through the cannula or the cannula site. If the needle size is larger than the cannula allows, it may have to be passed through the cannula site with the cannula temporarily removed (ssss1). The cannula is removed from the site while the assistant blocks gas exit, usually by digitally obstructing the defect. The instrument is placed through the cannula, and when it is exiting through the cannula end, the needle is either backloaded or the suture is grasped 2 cm from the swaged end and introduced into the abdomen through the cannula site (ssss1). The cannula through which the instrument is positioned is then immediately replaced in the site to minimize gas leakage.