Laparoscopic surgery was pioneered in the early 1980s, although the idea is not new. The main principle was to reduce the impact of surgery on the patient without compromising the procedure’s effectiveness. Today, laparoscopic surgery is being utilized in a greater number of procedures. Advantages of laparoscopy in comparison with conventional surgery are plenty e.g. there is minimal parietal trauma, so post operative pain, infection and dehiscence are much reduced and cosmetic results are greatly improved, short stay in the hospital and short convalescence. Avoidance of exposure, cooling, desiccation and forced retraction of abdominal tissues and organs.Modification of port sites and uses entails better visualization, less dissection less need for additional ports, less operative time and better results. As in cholecystectomy which can usually done by four ports but in our study, optimization of port sites enable better management of specific situations such as an additional port in the left lower quadrant in concomitant appendicectomy or in the left hypochondrium for retraction of the left lobe of the liver or in the right lower quadrant to retract the omentum. The telescope was put in the right mid-abdomen at the edge of the rectus muscle in case of dense midline adhesion or in put remote from the gravid uterus.In other study, two-port technique was used but not widely accepted. In hernia repair, three trocars usually used, one at the umbilicus, the other two are placed bilaterally at the same level at the edge of the rectus muscle. In our study, the working ports were put in the hypogastric region to have a shorter access to the operative filed. In TEP, creation of the extraperitoneal space by blunt dissection using the classical stone forceps instead of the expensive balloon. Sometimes an additional supra-umbilical port to ease mesh placement. In other study, a midline placement of the three trocars minimizes the chance of intraperitoneal insertion.In conclusion, we may suggest that port sites, numbers, uses and approaches can be tailored to each specific situation.