**2. Types of laparoscopic access injuries**

During the insertion of a Veress needle or during the blind or open placement of a trocar, injuries may be sustained to viscera and vessels that are either in their normal anatomical position (type 1 injuries) or in an anatomically altered position (type 2 injuries). Examples of type 2 injuries are those to a loop of bowel adherent to the anterior abdominal wall or to a major vessel graft in a subcutaneous position from bypass surgery such as a femoro-femoral crossover graft [2].

Visceral injury occurs in 0.04% and major vessel injury occurs in 0.02–0.04% of all laparoscopic procedures. More than half of these injuries occur during the insertion of the primary trocar [2]. Injuries to major vessels at the time of laparoscopy are still a leading cause of death. Minor complications, such as postoperative infection, subcutaneous emphysema, extraperitoneal insufflation, and trocar site hernia, are also associated with laparoscopic entry.
