At the department of obstetrics and gynaecology at the University of Graz laparoscopy in the obese women was modified. The pneumoperitoneum is introduced by placing the Verres needle through the pouch of Douglas. An umbilical incision through the fascia is made which admits the index finger of the left hand. Under control by the finger and elevation of the wound with clips the introduction of the trocar becomes safe. The technique is described in detail. The advantages and possible complications of this method are discussed and the first 25 cases reviewed.