Veress needle insertion in the left hypochondrium in creation of the pneumoperitoneum.
OBJECTIVE
To test the efficacy of the puncture in the left hypochondrium as an alternative method.


METHODS
Sixty-two patients randomly distributed into two groups were studied: Group LH, puncture in the left hypochondrium (n=30), and Group ML, puncture in the abdominal midline (n=32). The following were assessed: needle positioning tests, number of failed attempts at needle insertion, and time needed for creation of pneumoperitoneum. Gas flow, volume and intraperitoneal pressure were recorded at every 20 seconds, until a 12 mmHg pressure was reached inside the peritoneal cavity.


RESULTS
A similar number of positive results for the needle positioning tests were observed in both groups. Two failed attempts to reach the peritoneal cavity were observed in Group ML and one in Group LH. The time necessary for the creation of pneumoperitoneum was on average 3 minutes and 46 seconds for Group LH, and 4 minutes and 2 seconds for Group ML. Average gas flow, volume and pressure were equivalent for both groups.


CONCLUSIONS
Puncture in the left hypochondrium was as effective as puncture in the abdominal midline for the creation of pneumoperitoneum.
Azevedo
Otávio Cansanção de
OC
Service of Surgical Gastroenterology, Public Servant Hospital of the State of São Paulo, Federal University of São Paulo (UNIFESP), Rua Botucato 740, 04023 São Paulo (SP), Brazil.
Azevedo
João Luiz Moreira Coutinho
JL
Sorbello
Albino Augusto
AA
Miguel
Gustavo Peixoto Soares
GP
Guindalini
Rodrigo Santa Cruz
RS
Godoy
Antônio Cláudio de
AC
D000005:Abdomen / Q000502:physiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009339:Needles; D011028:Pneumoperitoneum, Artificial / Q000295:instrumentation* / Q000379:methods; D011312:Pressure; D011446:Prospective Studies; D011677:Punctures / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors