A novel, minimally invasive diagnostic laparoscopy procedure is described in this report. After positioning a percutaneous trocar and inducing CO2 pneumoperitoneum, a flexible endoscope is introduced through the trocar to inspect intra-abdominal organs, including the surface of the liver, the gallbladder, the stomach, the intestine, the pelvic organs, and free intraperitoneal fluid. Simple procedures such as gathering histological or cytological samples, intraperitoneal lavage, collecting peritoneal fluid for culture, removing adhesions and cyst puncturing are carried out at the endoscopic surgeon's discretion through 1 or 2 working channels. Only a single incision is necessary and, unlike Natural Orifice Translumenal Endoscopic Surgery, visceral iatrogenic perforations are unnecessary.
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