Page 3 - Jourmal of World Association of Laparoscopic Surgeon

WJOLS

10.5005/jp-journals-10033-1171
ORIGINAL ARTICLE Veress Needle: A Safe Technique in Modern Laparoscopic Era
Veress Needle: A Safe Technique in Modern

Laparoscopic Era

Shailesh Kumar, Shubhendu Bhaduri, Abu Masood Ansari, Suchita Tripathi, Priyadarshi Dikshit

ABSTRACT that almost 50% of complications in laparoscopic surgery
are related to primary access.
Background: Prospective analytical study to evaluate the
Veress needle technique for creating pneumoperitoneum in Some complications like gas embolism, major vascular
terms of safety profile. injury and visceral injuries are underreported as advocated

Materials and methods: A total of 4,014 patients undergoing by some authors. 5,7
laparoscopic surgery for different reasons in which Veress In high volume center there are similar bowel injury but
needle was the technique to create pneumoperitoneum were no, major vascular injury with the open technique. Some
included in the study during the period of January 2008 to
September 2012. studies have shown even more complications with open
Results were evaluated by analysing the data through SPSS technique compared to closed technique. 8
version 16. In our study we used Veress needle in most of our cases
Results: Total 27 patients developed complications in terms and found it to be more convenient than open technique.
of abdominal wall emphysema 12 (44%), omental injury Complications rate were found quiet comparable and even
11 (40.7%), small bowel injury 2 (7.4%) and mesenteric vascular lower, particularly in patients with BMI <30 in comparison
injury 2 (7.4%).
Among these complications majority of patients were having to open technique. Open technique were reserved for the
BMI > 30 (78%). patients having history of abdominal surgery for any other
All the complications were managed by simple measures reasons and in case of failure of Veress needle technique.
laparoscopically.
Our experience with 4,014 patients undergoing
Conclusion: Veress needle technique for creating laparoscopic surgery during the period of January 2008 to
pneumoperitoneum is comparable with open technique,
particularly in patients with BMI < 30. September 2012 in which Veress needle technique was used
for primary access to abdominal cavity. Patients who were
Keywords: Veress needle, Pneumoperitoneum complications, converted into open method due to some or other reasons
BMI.
were not included in our study.
How to cite this article: Kumar S, Bhaduri S, Ansari AM,
Tripathi S, Dikshit P. Veress Needle: A Safe Technique in MATERIALS AND METHODS
Modern Laparoscopic Era. World J Lap Surg 2013;6(1):1-5.
Source of support: Nil In our study, total of 4,014 patients were included who
underwent laparoscopic surgery for different reasons. The
Conflict of interest: None declared
surgeries were performed by the surgeons and gynecologists
having experience of more than 5 years in the field of
INTRODUCTION
laparoscopic surgery. This study was conducted at PGIMER
Gaining access into the abdomen has been a challenging Dr RML Hospital New Delhi between the period of January
issue in terms of complications. Access is associated with 2008 and September 2012.
injuries to the gastrointestinal tract and major blood vessels, In all these patients Veress needle technique was used
and at least 50% of these major complications occur prior for primary access. The Veress needle was introduced
to commencement of the intended surgery. 1,2 through the umbilical scar by giving a supraumbilical
Laparoscopy is widely used for different surgical and curvilinear skin incision. In all patients abdominal wall was
gynecological procedures. Access to the peritoneal cavity lifted with nondominant hand or by the assistant to facilitate
and creation of pneumoperitoneum is the first and foremost safe and easy introduction of Veress needle. The entry into
important step. 3 the abdominal cavity was confirmed by double click sound
Among the different methods of primary access in and later on by Drop test.
laparoscopy, the popular ones being the Veress needle and CO insufflation was confirmed by the obliteration of
2
4
Hasson’s technique. The Veress needle technique is still liver dullness on percussion and tympanitic sound of the
being used by many surgeons and gynecologist as an gold abdominal cavity. All the complications which occurred
5,6
standard technique while others recommend the open during primary access were recorded and analyzed with the
method of access as gold standard. Some studies have shown help of SPSS version 16.
World Journal of Laparoscopic Surgery, January-April 2013;6(1):1-5 1