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Left subcostal closed (Veress needle) approach is a safe method for creating a pneumoperitoneum
1Royal Cornwall Hospital, Treliske, Truro, United Kingdom.
Background:
The left subcostal closed approach utilizing the Veress needle has been the preferred method at one surgical practice for the past 5 years. The aims of this study were to determine whether this was a safe method for creating a pneumoperitoneum and its success rate.
Methods:
The medical records for all laparoscopic procedures performed at one practice from 1996 through 2001 were reviewed.
Results:
A total of 352 laparoscopic cases were reviewed. The median age of the patients was 55 years (range, 14-72), with a sex ratio of 1 male to 3.5 females. The left subcostal closed approach was not attempted in 8 patients (2%) due to left subcostal surgical scars. The left subcostal approach was successful in 342 of 344 attempts (99%). In 2 patients the method failed because the Veress needle hole could not be placed in the peritoneal cavity. An omental hematoma in one patient was the only complication.
Conclusion:
The left subcostal closed approach is a safe and effective method for creating a pneumoperitoneum.
