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. 2011 Jul 13;25(9):2773–2843. doi: 10.1007/s00464-011-1799-6
Level 4 Direct open access is a simple and reproducible technique for accessing the preperitoneal space.
Access by transperitoneal visualization is an alternative but is associated with the risks of entering the peritoneal cavity.
Suprapubic Veress needle technique also is used by few surgeons.