Step 1. Trocar placement E. Liatsikos, Panagiotis Kallidonis

Step 2: Trocar placement

• A Gelpoint (Applied Medical Resources Corporation, California, USA) multi-instrument port is inserted through an umbilical incision.
• The peritoneal cavity is then carefully inspected, with a 30° lens extra long camera (Hopkins endoscopic camera, Karl Storz, Tuttlingen, Germany).
• For  vaginal access, a finger or an obturator is inserted to apply tension on the posterior vagina fornix. Sharp and blunt dissection  is performed transvaginally and an appropriate access at the posterior fornix is established for the insertion of the flexible cannulas. The insertion of the vaginal trocars is performed under direct vision. Extra care should be taken at this step to avoid rectal injury during insertion of the vaginal multi-port.