To compare the outcome of "one scalpel and one scissors" in terms of feasibility and complications with a well-established and widely practiced open access technique (OAT) for a laparoscopic procedure.

One hundred and ninety-six participants undergoing transabdominal laparoscopic upper urinary tract surgery in Zhongshan People's Hospital from October 2018 to October 2020 were collected and analyzed retrospectively, including 97 cases of Group A for "one scalpel and one scissors" and 99 cases of Group B for OAT. The primary endpoint was major complications (bowel, major vessel, and solid organ injury having the potential of causing Clavien-Dindo complication of grade 3 and above) and the secondary endpoint was port access time and minor complications (Clavien-Dindo complication of grade 1 or 2 such as access port-site infection and bleed, subcutaneous emphysema, access port-site pain, entry reattempted, and gas leakage) directly related to access. Patients were assessed for feasibility and complications.

There was no statistical difference in major complications between Group A and Group B, however, Group A was found to be superior to Group B, in terms of port access time [(90±19) svs (193±25) s, P<0.001), gas leakage (2.06% vs 10.10%, P=0.019), subcutaneous emphysema (1.03% vs 8.08%, P=0.018), access port-site infection (2.06% vs 9.09%, P=0.033), access port-site pain (3.09% vs 12.12%, P=0.017).

"One scalpel and one Scissors" method to establish laparoscopic observation access for trans peritoneal laparoscopic surgery is a good and safe technique of laparoscopic access. The technique of "one scalpel and one Scissors" is worthy of popularization and application by laparoscopic surgeons.