Study of two laparoscopic entry techniques Closed (Veress needle) technique and Open (Hasson’s) technique to evaluate safety, efficacy and their associated complications

2021 ◽  
Vol 20 (1) ◽  
pp. 01-05
Author(s):  
Basavaraj Yenagi ◽  
Keyword(s):  
Veress Needle ◽  
Needle Technique ◽  
Laparoscopic Entry

scholarly journals COMPARISON OF A NEW VERESS NEEDLE ENTRY METHOD AND CLASSIC VERESS NEEDLE ENTRY METHOD IN GYNECOLOGIC LAPAROSCOPY: A PROSPECTIVE RANDOMIZED STUDY

2018 ◽  
Vol 6 (2) ◽  
pp. 74-79
Author(s):  
Uğurkan Erkayıran ◽  
Bülent Köstü ◽  
Alev Özer
Keyword(s):  
Horizontal Plane ◽  
Randomized Study ◽  
Veress Needle ◽  
Operative Outcomes ◽  
Laparoscopic Entry ◽  
Gynecologic Laparoscopy ◽  
The Mean ◽  
Group 2 ◽  
Needle Entry ◽  
Group 1

Background: To compare cranial 15º angulation of Veres needle to classic Veress needle entry in closed laparoscopic entry in obese patients. Method: Patients with BMI index>30 were divided into two groups. Initial entry into the abdomen in Group 1 (n=29) was performed with the intraumbilical insertion of Veress needle in 90o angle relative to the horizontal plane. In Group 2 (n=31) the Veress needle was placed intraumbilically in a cranial direction, the tip of the needle towards the thoracic cavity, with an angle of 15o to the horizontal plane. Two groups were compared with respect of the operative outcomes. Results: In Group 2, the mean number of Veress needle entries attempt was significantly lower than Group 1 (p=0.01). Time to insertion of the Veress needle was found to be significantly shorter in Group 2 than in Group 1 (p<0.001). While entry failure occurred in 3 patients in Group 1 (10.3%), no failures were monitored in any patients in Group 2 (p= 0.01). Complication rate was significantly lower in Group 2 than in Group 1 (p= 0.03). Conclusion: Placement of Veress needle intraumbilically in a cranial direction at 15°angle to the horizontal plane increases entry success and reduces complications.

scholarly journals Comparison of Complications between Direct Trocar Insertion Versus Veress Needle for Creation of Pneumoperitoneum in Patients Undergoing laparoscopic Cholecystectomy: A Randomized Control Trial

2021 ◽  
pp. 294-299
Author(s):  
Kamran Hamid ◽  
Shabbir Ahmad ◽  
Bahzad Akram Khan ◽  
Muhammad Faheem Answer ◽  
Amer Latif ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Needle Insertion ◽  
Veress Needle ◽  
P Value ◽  
Surgical Department ◽  
Trocar Insertion ◽  
Laparoscopic Entry ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Direct Trocar Insertion

Aim: To compare the outcomes in term of complication of Veress Needle Insertion (VNI) to Direct Trocar Insertion (DTI) for creation of pneumoperitoneum in laparoscopic cholecystectomy. Design: Randomized controlled trial Place and Duration of Study: The current analysis was conducted at Khawaja Muhammad Safdar Medical College Surgical Department, Allama Iqbal Memorial Hospital and Govt. Sardar Begum Teaching Hospital, Sialkot from September 27, 2017, to September 26, 2020. Methodology: A total of six hundred and eight (n=608) patients, having age 30 to 75 years planned for laparoscopic cholecystectomy were included in this study. Patients were randomly divided into two groups, Group A (Direct Trocar Insertion), Group B (Veress Needle Insertion). Both groups had age and sex matched males and female. All trocars and veress needle used were disposable, with a safety shield. The primary outcome of our study was to compare the complications to assess the safety levels, while total time taken by the procedure and mean time for laparoscopic entry were the secondary end points. The collected data was analyzed by using software SPSS version 22. Chi-square test was used to check the significance of variance. P-value less than 0.05 remained the statistically significant. Results: The complication rate in VNI group were significantly greater than the DTI group (p < 0.01), the duration of surgery between the two groups was not significantly different (p > 0.05), but we found statistically significant difference in mean laparoscope insertion time (DTI 3.4+ 1.4 versus VNI 4.8+ 0.7 minutes, p < 0.001). Conclusion: From the results of our study, it can be concluded that the direct trocar insertion is a safe alternative to veress needle insertion in laparoscopic cholecystectomy as it is associated with fewer complications.

scholarly journals Comparison Effect of Direct Trocar and Veress Needle Entry Techniques on Gut Functions after Laparoscopic Procedures: Randomized Clinical Trial

2016 ◽  
Author(s):  
Taylan Şenol ◽  
Mesut Polat ◽  
Enis Özkaya ◽  
İlhan Şanverdi ◽  
Birsen Konukçu ◽  
...  
Keyword(s):  
Laparoscopic Approach ◽  
The Body ◽  
Veress Needle ◽  
Intraabdominal Pressure ◽  
Intraperitoneal Pressure ◽  
Laparoscopic Entry ◽  
Significant Difference ◽  
Group 2 ◽  
Needle Entry ◽  
Index Comparison

<p><strong>OBJECTIVE:</strong> The aim of this study was to compare the effect of two different laparoscopic entry methods on postoperative gastrointestinal functions.<br /><strong>STUDY DESIGN:</strong> A total of 108 women who underwent gynecological operation via laparoscopic approach with different indications were randomly assigned to 2 groups: In Group 1 pneumoperiteneum was achieved by direct trocar entry (n=72), while in group 2, Veress needle was used.<br /><strong>RESULTS:</strong> Correlation analyses showed a significant association between the technique for abdominal entry and postoperative hemoglobin and hematocrit concentrations, time to maximal intraabdominal pressure and the body mass index. Comparison of groups with different laparoscopic entry techniques showed a significant difference between groups in terms of postoperative hemoglobin and hematocrit concentrations, time to obtain maximal intraabdominal pressure and time to first flatulence (p &lt; 0.05, Table 2). No intra or postoperative complications was observed.<br /><strong>CONCLUSION:</strong> Direct or Veress needle entry methods were both safe to create pneumoperitoneum with similar postoperative gastrointestinal functions except for earlier first flatulence in Veress needle group while direct trocar entry was found to be associated with favorable postoperative blood count and shorter duration to obtain enough intraperitoneal pressure.</p>

scholarly journals The Frequency of Common Complications of Veress Needle in Laparoscopic Cholecystectomy

2017 ◽  
Vol 3 (2) ◽  
pp. 4-9
Author(s):  
Faiz -Ur- Rahman ◽  
Fazli Junaid ◽  
Bilal Khattak ◽  
Azhar Shah ◽  
Arshad Amin
Keyword(s):  
Abdominal Wall ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Veress Needle ◽  
Common Complication ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Needle Technique ◽  
Male To Female

METHODOLOGYThe study was conducted in department of surgery, Lady Reading Hospital Peshawar within six months and it was descriptive cross sectional study. In this study a total of 177 patients were observed. The age ranges were 21 to 65 years and male to female ratio was 1:2. The most common complication was abdominal wall hemorrhage in 22% patients while 18% patients had omental injury. The abdominal wall emphysema was observed in 10% patients.OBJECTIVETo determine the frequency of common complications of Veress Needle used for creating pneumoperitoneum in laparoscopic cholecystectomyCONCLUSIONOur study showed that veress needle technique is safe, easy and cost effective for primary access to create pneumoperitonium.

scholarly journals A novel Veress needle mechanism that reduces overshooting after puncturing the abdominal wall

2021 ◽  
Author(s):  
Roelf R. Postema ◽  
David Cefai ◽  
Bart van Straten ◽  
Rein Miedema ◽  
Latifa Lesmana Hardjo ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Ex Vivo ◽  
Bowel Perforation ◽  
Veress Needle ◽  
Safety Mechanism ◽  
Laparoscopic Entry ◽  
Significant Difference ◽  
Life Threatening ◽  
Decoupling Mechanism ◽  
Initial Action

Abstract Background Complications that occur in laparoscopic surgery are often associated with the initial entry into the peritoneal cavity. The literature reported incidences of Veress needle (VN) injuries of e.g. 0.31% and 0.23%. In a 2010 national survey of laparoscopic entry techniques in the Canadian General Surgical practice, 57.3% of respondents had either experienced or witnessed a serious laparoscopic entry complication like bowel perforation and vascular injury. As those complications are potentially life threatening and should be avoided at all costs, improving safety of this initial action is paramount. Methods Based on a bare minimum design approach with focus on function expansion of existing components, a new Safety mechanism was developed for the VN that decreases the risks of VN overshooting. The mechanism works by preventing the puncturing acceleration of the tip of the VN by decoupling the surgeon’s hand from the VN immediately after entering the abdomen. Results Based on a set of requirements, a first prototype of the VN+ with force decoupling safety mechanism is presented and evaluated on an ex vivo porcine abdominal wall tissue model in a custom setup. The experiments conducted by two novices and one experienced surgeon indicated a significant difference between the attempts with a standard, conventional working VN (41.4 mm [37.5–45 mm]) and VN+ with decoupling mechanism (20.8 mm [17.5–22.5 mm]) of p < 0.001. Conclusion A new decoupling safety mechanism was integrated successfully in a standard VN resulting in a VN+ . The results from the pilot study indicate that this new VN+ reduces overshooting with a minimum of 50% in a standardised ex vivo setting on fresh porcine abdominal wall specimens.

Sign in / Sign up

Export Citation Format

Share Document