A few days ago, I operated a patient, male, 43, cholelithiasis, with previous op, (diffusse peritonitis), we suspected adherences in the preop. We could do the pneumoperitoneum, but we couldn't introduce the camera, trough the umbilical hole, so I changed the place to the left hole (I do french approach). After this I did the upper hole, through this I introduced the hook and could release the adherences, especially in the right side, so it was possible to do the fourth hole. Once released the adherences, put the camera as usually through the umbilical hole. It was an alternative to the conversion. Cholecystectomy was no difficult, with no complication.