The reasons for placing a free hand into the abdominal cavity were big colonic tumor with massive adhesions to adjacent organs or abdominal wall (2 cases), difficult dissection due to short splenic pedicle, coagulation disorder or splenic abscess (3 cases), small invisible distal pancreatic tumor (1 cm) which required direct touch sensibility (1 case), bleeding in distal pancreatectomy (1 case) or choledochal cyst resection.