Laparoscopic Entry Technique Using a Veress Needle Insertion with and without Concomitant CO₂ Insufflation: A...

Area of Science:

• Minimally Invasive Surgery
• Surgical Techniques
• Anesthesiology

Background:

• Laparoscopic surgery requires initial insufflation for visualization.
• Veress needle insertion is a critical step for establishing pneumoperitoneum.
• Different CO2 insufflation techniques may impact procedural efficiency and safety.

Purpose of the Study:

• To compare the efficacy of concomitant versus subsequent CO2 insufflation for Veress needle entry.
• To evaluate the number of attempts and time required for successful Veress needle insertion.
• To assess complication rates associated with each insufflation technique.

Main Methods:

• Randomized controlled trial conducted at a university teaching hospital.
• 95 patients undergoing laparoscopic surgery were randomized into two groups: concomitant (Con) and subsequent (Sub) CO2 insufflation.
• Primary outcome measures included time to adequate insufflation and number of attempts for Veress needle entry.

Main Results:

• Concomitant insufflation showed a significantly higher first-attempt success rate (89%) compared to subsequent insufflation (67%) (p=0.01).
• Median insufflation times were similar between groups (103.5s vs 113.0s, p=0.16).
• Incidence of preperitoneal insufflation, failed entry, and major complications were comparable between the two techniques.

Conclusions:

• Veress needle entry with concomitant CO2 insufflation is associated with improved first-attempt success rates.
• The concomitant technique offers a procedural advantage without increasing insufflation time or complication risks.
• This finding supports the use of concomitant CO2 insufflation for more efficient Veress needle insertion in laparoscopic procedures.