In this report we present our preliminary experience using a recently developed sonolaparoscope. The 7.5 MHz rotating transducer, fixed to the tip of the laparoscope, produces a sector scan display of 180 degrees. We have used this technique in nine patients: five with cirrhosis and four with focal lesions of the liver. Laparoscopic sonography (LS) visualized two small nodular lesions in two cases of cirrhosis that did not show up with conventional ultrasonography (US). In one case of small hepatocellular carcinoma (HCC) located in the seventh hepatic segment, the lesion was not revealed. The ultrasound patterns of cirrhosis, hepatic cyst, and hemangioma were typical. We also performed ultrasonically guided biopsies. We concluded that laparoscopic sonography may be useful in the study of cirrhosis and in oncological patients for the screening of small hepatic lesions and that it could, in future, represent a preoperative step for liver surgery.