Local anesthesia was utilized in port sites for improved postoperative analgesia, which minimized narcotic requirements after surgery.

A modified Hasson technique was used for initial entry and insufflation via direct visualization of the fascial opening and trocar insertion without use of blindly inserted insufflation devices. Initial entry was a supraumbilical (or subxiphoid), modified Hasson, open-fascia technique under direct vision. The fascia, elevated by a towel clip, was incised in the midline sufficiently to pass a 10-mm cannula (with the trocar removed) directly into the abdomen, angled away from the visible uterus. Ultrasound was not required in order to identify the uterus.

Patients were turned slightly to their left to minimize uterine compression of the vena cava, and low-level insufflation pressures were maintained throughout the procedures.

Fetal heart tones were checked preoperatively, again after induction of anesthesia, upon completion of the operation, in the recovery room, and every 4 hours until discharge the next morning.

Uterine contraction monitoring was done every 4 hours and if the patient reported unusual pain or contractions. Tocolytic agents were not utilized prophylactically.

All patients were monitored overnight for uterine irritability and fetal heart tone checks.