Veress needle insertion through left lower intercostal space for creating pneumoperitoneum: Experience with 75 cases

Area of Science:

• Laparoscopic surgery
• Surgical techniques
• Minimally invasive procedures

Background:

• Veress needle insertion (VNI) at the sub-umbilical fold (SUF) midline is linked to significant intra-abdominal injuries.
• Alternative VNI sites are needed to improve patient safety.

Purpose of the Study:

• To evaluate the safety and efficacy of VNI at the lower left intercostal space (LICS).

Main Methods:

• A prospective observational study measured skin fold thickness (SFT) at various sites.
• VNI was performed at LICS under laparoscopic guidance in 32 patients.
• The technique was further assessed in 43 patients undergoing laparoscopy, noting insertion ease, attempts, tactile feedback, and complications.

Main Results:

• Significantly less SFT was observed at LICS compared to SUF and Palmer's point.
• VNI at LICS was easily performed in a single attempt with clear tactile feedback.
• No intra-abdominal bleeding, hemopneumothorax, or visceral/vascular injuries occurred.

Conclusions:

• VNI at the LICS is a safe and effective method.
• This technique offers a reduced risk profile for laparoscopic procedures.