Safe Veress needle insertion.
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.
Cakir
Tebessum
T
Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey.
Tuney
Davut
D
Esmaeilzadem
Safa
S
Aktan
A Ozdemir
AO
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