Laparoscopic suturing of a pedicle of omentum placed across the perforation completes the Graham patch. Reproduced with permission from Shah AS, Pappas TN. Atlas of Laparoscopic Surgery. In: Pappas TN, Chekan EG, Eubanks S, eds. Laparoscopic Repair of Perforated Ulcer and Vagotomy. Philadelphia, Pa: Current Medicine; 1999.