title: Veress needle insertion in the left hypochondrium in creation of the pneumoperitoneum.
abstract: 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.
authors.affiliation: 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.
authors.forename: Otávio Cansanção de
authors.initials: OC
authors.lastname: Azevedo
authors.forename: João Luiz Moreira Coutinho
authors.initials: JL
authors.lastname: Azevedo
authors.forename: Albino Augusto
authors.initials: AA
authors.lastname: Sorbello
authors.forename: Gustavo Peixoto Soares
authors.initials: GP
authors.lastname: Miguel
authors.forename: Rodrigo Santa Cruz
authors.initials: RS
authors.lastname: Guindalini
authors.forename: Antônio Cláudio de
authors.initials: AC
authors.lastname: Godoy
mesh_terms: 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