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Related Experiment Video

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A negative pressure-based visualization technique for abdominal Veress needle insertion.

Takanobu Onoda1,2, Masanori Sato3, Kakeru Torii1

  • 1First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.

Langenbeck'S Archives of Surgery
|March 31, 2022
PubMed
Summary

A new negative pressure visualization (NPV) technique for Veress needle insertion in laparoscopy eliminated failed entries and reduced emphysematous complications. This method clearly visualizes needle entry into the abdominal cavity, improving laparoscopic surgery safety.

Keywords:
Extraperitoneal emphysemaLaparoscopic entryNegative pressure visualizationPneumoperitoneumPropensity score–matchingVeress needle

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Area of Science:

  • Laparoscopic surgery
  • Surgical techniques
  • Minimally invasive procedures

Background:

  • Veress needle insertion is crucial for creating pneumoperitoneum in laparoscopy.
  • Current methods for confirming needle placement can yield ambiguous results.
  • Direct visualization of peritoneal puncture is often lacking with conventional techniques.

Purpose of the Study:

  • To validate a novel negative pressure-based technique for Veress needle insertion.
  • To assess if the negative pressure visualization (NPV) technique offers instant visualization of peritoneal entry.
  • To compare the safety and efficacy of NPV against the conventional (CON) technique.

Main Methods:

  • A retrospective study of 761 patients undergoing laparoscopic hernioplasty from 2003-2021.
  • Patients were divided into CON and NPV groups for Veress needle insertion.
  • Propensity score matching (1:1) was used to create comparable groups (105 pairs) for analysis.

Main Results:

  • The NPV group had zero failed entries, compared to 7.6% in the CON group (p=0.004).
  • No extraperitoneal emphysema occurred in the NPV group, versus 6.7% in the CON group (p=0.007).
  • Omental or mesenteric emphysema incidence did not differ significantly between groups.

Conclusions:

  • The negative pressure visualization technique effectively eliminates failed Veress needle entries.
  • NPV significantly reduces the incidence of extraperitoneal emphysema during laparoscopic procedures.
  • This technique provides a simple and reliable method to confirm needle entry into the abdominal cavity.