Transdiaphragmatic approach to the pericarium through the use of the laparoscope is a safe and rapid way to obtain biopsy of the pericardium and create a window. No drainage tubes are needed: pericardial fluid is absorbed by the peritoneum; there is no need for double lumen tubes for one lung ventilation; and the laparoscopy incisions are small and almost painless. [ABSTRACT FROM AUTHOR]