The abdominal cavity is usually observed by insertion of a
12mm trocar into the umbilical part, and 5mm trocars
into the left abdomen and the suprapubic region, and
pneumoperitoneum. In the case that the appendix can
not be detached by laparoscopic instruments due to high
adhesion to the retroperitoneum, a 12mm trocar is
additionally inserted immediately above the appendix at
the right abdomen for appendicitis which the wall of the
appendix is probably damaged by the laparoscopic
instrument due to embrittlement. The trocar is removed,
the right second finder is inserted, the appendix is
laparoscopically detached, and mobilization is conducted.