In general, sharp “cold” dissection with endoshears is safer than using monopo­lar cautery or bipolar energy and will avoid inadvertent burn injury and delayed enterotomy. There is a clear difference between “lmy” adhesions (nonvascular), which can usually be teased apart and easily transected, and “dense” adhesions which are vascularized or inammatory, which will not separate without sharp dis­section. The two guiding principles in adhesiolysis are preventing bowel injury and maintaining hemostasis. Traction and counter-traction principles are just as impor­tant in laparoscopic adhesiolysis as in open surgery. However, the amount of coun­ter-traction provided by an assistant is hard to estimate and control. Serosal tearing to bowel wall can occur passively by assistant traction on the bowel against a point of xation. Overzealous grasping of friable bowel can result in partial- or full-thick­ness tearing. Therefore, we prefer limiting the traction applied by the assistant and use the assistant only when necessary during this phase of the operation. The other important consideration is to stay in the proper dissection plane. When dissecting off the abdominal wall, a clear plane exists on the parietal peritoneum. It tends to be avascular. When dissecting between two loops of bowel or two loops of mesentery, it is important to go slowly and stay in the avascular plane. If bleeding occurs, it is most likely due to an improper dissection plan. After extensive adhesiolysis, it is important to check for serosal tears and enterotomies prior to moving on with the resection, and this should be repeated again at the end of the procedure. If there is any question about injury, we recommend marking the area with a suture or an endoloop for closer inspection and denitive suture repair later during the case.