This video demonstrate A Veress needle is a spring-loaded needle used to create pneumoperitoneum for laparoscopic surgery. Of the three general approaches to laparoscopic access, the Veress needle technique is the oldest and most traditional and most widely used technique of access.

Laparoscopic surgery has revolutionized modern surgical practice by allowing procedures to be performed through small incisions with minimal tissue trauma, faster recovery, and reduced postoperative pain. One of the most critical steps in laparoscopic surgery is safe abdominal entry. Among various entry techniques, the Veress needle technique remains one of the most widely used closed methods for creating pneumoperitoneum. At World Laparoscopy Hospital (WLH), surgeons are trained to perform this technique with high precision, emphasizing patient safety and evidence-based surgical principles.

World Laparoscopy Hospital is a globally recognized center of excellence in minimal access surgery, offering advanced training programs with theoretical teaching, hands-on simulation, and live surgical demonstrations. The institute focuses on developing skilled surgeons to ensure safer surgical outcomes worldwide.

Principle of Veress Needle Technique

The Veress needle is a spring-loaded needle used to create pneumoperitoneum by insufflating carbon dioxide into the peritoneal cavity. The closed entry technique using the Veress needle is one of the most commonly used methods for laparoscopic access, although alternative techniques such as open (Hasson) entry and direct trocar insertion are also practiced. No single entry technique is universally superior; the choice depends on patient factors and surgeon experience.

Studies show that more than half of major laparoscopic complications occur during the initial entry phase, highlighting the importance of mastering safe entry techniques.

Step-by-Step Technique

At WLH, surgeons are trained to follow standardized safe entry protocols. The typical steps include:

1. Patient Preparation
   Preoperative evaluation is done to identify risk factors such as previous abdominal surgery, obesity, or pelvic masses, which can increase entry complications.

2. Selection of Entry Site

   • Umbilicus is most commonly used due to minimal tissue thickness.

   • Palmer’s point or other alternative sites are used if adhesions or previous surgery are suspected.

3. Needle Insertion
   The insertion angle varies with body habitus—about 45° in thin patients and up to 90° in obese patients.

4. Confirmation of Correct Placement
   The most reliable indicator of correct placement is low intraperitoneal pressure during CO₂ insufflation (usually ≤8–10 mmHg).

5. Creation of Pneumoperitoneum
   After confirming placement, CO₂ is insufflated to create working space for laparoscopic instruments.

Safety Considerations

Safe Veress needle use requires meticulous technique. Blind insertion carries risks, and incorrect handling can enlarge small injuries to significant visceral or vascular damage.

Major risk factors for entry complications include:

• Previous abdominal surgery

• Extreme body habitus

• Large pelvic or abdominal masses

Rare but serious complications such as CO₂ embolism and vascular injury may occur, though incidence is very low.

Advantages of Veress Needle Technique

• Small incision and minimal tissue trauma

• Rapid creation of pneumoperitoneum

• Widely familiar and cost-effective

• Suitable for most routine laparoscopic procedures

However, some studies suggest higher rates of failed entry or minor complications compared with direct trocar or open techniques, emphasizing the need for proper training.

Training at World Laparoscopy Hospital

At WLH, surgeons are trained through structured programs focusing on:

• Simulation-based learning

• Hands-on practice

• Real surgical case observation

• Complication prevention and management

The hospital follows the philosophy of “Skilled Surgeon, Safer Surgery,” ensuring that trainees develop both theoretical knowledge and practical competence.

Conclusion

The Veress needle technique remains a cornerstone of laparoscopic access due to its simplicity and widespread acceptance. However, it requires precise technical skill and strict adherence to safety protocols to minimize complications. Training at institutions like World Laparoscopy Hospital plays a crucial role in teaching surgeons safe laparoscopic entry techniques, ultimately improving patient outcomes and advancing the field of minimally invasive surgery worldwide.