title: Safe Veress needle insertion.
abstract: OBJECTIVE
  For laparoscopic surgery, the creation of pneumoperitoneum still remains a must. The insertion of a Veress needle or a trocar is never perfectly safe, and almost every kind of intraabdominal organ injury due to these insertions has been reported worldwide. Here, we describe a safe technique for creating pneumoperitoneum.
  
  
  METHODS
  For the creation of pneumoperitoneum, under direct vision, the linea alba was elevated with two towel clips and then the Veress needle was inserted. We reviewed 368 patients operated on with this technique for complication rates. Ultrasound images were obtained before and during abdominal-wall lifting in 10 patients.
  
  
  RESULTS
  There were no injuries due to the insertion of the Veress needle or trocars. In 90% of the patients, pneumoperitoneum was created successfully on the first attempt. Ultrasound examination demonstrated a mean extra safe area of 11.8 mm during abdominal-wall lifting with this technique.
  
  
  CONCLUSIONS
  Elevating the linea alba during Veress-needle insertion is safe.
authors.affiliation: Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey.
authors.forename: Tebessum
authors.initials: T
authors.lastname: Cakir
authors.forename: Davut
authors.initials: D
authors.lastname: Tuney
authors.forename: Safa
authors.initials: S
authors.lastname: Esmaeilzadem
authors.forename: A Ozdemir
authors.initials: AO
authors.lastname: Aktan
mesh_terms: D034861:Abdominal Wall / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D009339:Needles; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D013525:Surgical Instruments; D014463:Ultrasonography