title: Left subcostal closed (Veress needle) approach is a safe method for creating a pneumoperitoneum.
abstract: BACKGROUND
  The left subcostal closed approach utilizing the Veress needle has been the preferred method at one surgical practice for the past 5 years. The aims of this study were to determine whether this was a safe method for creating a pneumoperitoneum and its success rate.
  
  
  METHODS
  The medical records for all laparoscopic procedures performed at one practice from 1996 through 2001 were reviewed.
  
  
  RESULTS
  A total of 352 laparoscopic cases were reviewed. The median age of the patients was 55 years (range, 14-72), with a sex ratio of 1 male to 3.5 females. The left subcostal closed approach was not attempted in 8 patients (2%) due to left subcostal surgical scars. The left subcostal approach was successful in 342 of 344 attempts (99%). In 2 patients the method failed because the Veress needle hole could not be placed in the peritoneal cavity. An omental hematoma in one patient was the only complication.
  
  
  CONCLUSIONS
  The left subcostal closed approach is a safe and effective method for creating a pneumoperitoneum.
authors.affiliation: Royal Cornwall Hospital, Treliske, Truro, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Rohatgi
authors.forename: A L
authors.initials: AL
authors.lastname: Widdison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome