Abstract Abdominal entry at the time of laparoscopy re-mains the most critical stepin laparoscopic surgery. Transabdominal ultrasound (TAU) and cine magnetic reso-nance imaging (cine-MRI) are both non-invasive tools in the preoperative prediction of adhesions. Ultrasound is effective in detecting abdominal wall adhesions, but MRI is the best for intra-abdominal adhesions. Periumbilical ultrasound-guided saline infusion (PUGSI) is an excellent method for detecting subumbilical adhesions. Evaluate the most effective and rapid method for diagnosis of subumbilical adhesions before lapa-roscopic interference in gynecological practice. This study was carried out on 90 high-risk patients for subumbilical ad-hesions. All patients were subjected to medical history, phys-ical examination, laboratory investigations, and three tech-niques for subumbilical adhesions detection before laparo-scopic entry including cine-MRI, TAU, and PUGSI. PUGSI
for detection of subumbilical adhesions showed that the sen-sitivity of 94.7 % and a specificity of 90.1 %. With preopera-tive TAU, a sensitivity of 89.5 % and a specificity of 88.7 % were obtained. With cine-MRI, a sensitivity of 78.9 % and a specificity of 84.5 % were obtained. PUGSI is a more sensi-tive and rapid method than TAU and cine-MRI for detection of subumbilical adhesions before laparoscopic gynecological surgery