PNEUMOPERITONEUM

THE EFFECTIVENESS AND INTRA PERITONEAL EVENTS WHILE USING VERESS NEEDLE

Abstract

Introduction: Minimal access surgery has evolved enormously and
revolutionised surgical practice. With increasing use of Minimal access surgery, safety of methods of creating
Pneumoperitoneum have come under intense scrutiny. Objectives: To observe the effectiveness and intra
peritoneal events of using veress needle to create pneumoperitoneum in minimal access surgery. Study design:
Prospective observational study. Period: From April to June 2004. Setting: Department of Surgery at Norfolk
and Norwich University Hospital. Subject & Methods: 50 patients with male to female ratio 25:1 Veress Needle
14G was inserted infra umbilically through stab incision at angle of 45 degree. BMI (body mass index) and
abdominal thickness was recorded. Intra peritoneal events of flow of insufflated air, intraperitoneal position of
needle and intraperitoneal adhesions were recorded. Results: (28/50) 56% of patients achieved free flow, (18/50)
36% patients achieved free flow with traction. 44% of patients had free veress needle tip and 44% had tip in
omentum, 8% patients showed extra peritoneal air collection. All patients were fit enough to be discharged same
day. Discussion: Our study has revealed that body mass index (BMI) and skin fold thickness does not effect the
position of needle. With skin fold thickness increase free flow of air needs to be assisted by traction of abdominal
wall. Conclusion: We conclude that Veress needle can be safely used for creating pneumoperitoneum in patients
of any BMI and skin fold thickness.