 Under direct laparoscopic visualization, we placed three additional trocars; an 11-mm screw-type trocar in the umbilicus, a 6-mm screw-type trocar in the upper midline approximately 7 cm above the umbilicus, and 10/12 trocar in the lower midline about 7 cm below the umbilicus within and over the old hysterectomy scar. 
Under direct laparoscopic visualization , we placed three additional trocars ; an 11 - mm screw - type trocar in the umbilicus , a 6 - mm screw - type trocar in the upper midline approximately 7 cm above the umbilicus , and 10/12 trocar in the lower midline about 7 cm below the umbilicus within and over the old hysterectomy scar .