Laparoscopic needles and trocars: an overview of designs and complications

Although the gynecologist has utilized the laparoscope both diagnostically and therapeutically for several decades, laparoscopic surgery has only recently gained great acceptance in the general surgical and urologic community. However, the enthusiasm for this new technology for minimally invasive surgery must be dampened by the small incidence of complications, most of which occur during the creation of the initial pneumoperitoneum and, in particular, during the insertion of the Veress needle and the principal trocar. The purpose of this paper is to review needle and trocar designs, to describe the complications of their use, and to identify factors that may contribute to injury and those that will minimize the risk.