Related Experiment Videos
Direct needle insufflation for pneumoretroperitoneum: anatomic confirmation and clinical experience
1Department of Surgery, Veterans General Hospital-Taipei, National Yang-Ming University, School of Medicine, Taiwan, Republic of China.
Urology
|September 1, 1995
Summary
Direct needle insufflation safely creates pneumoretroperitoneum by moving the colon anteriorly when patients shift to a lateral position. This technique is effective for retroperitoneoscopic procedures.
Area of Science:
- Minimally Invasive Surgery
- Surgical Anatomy
- Anesthesiology
Background:
- Establishing pneumoretroperitoneum is crucial for retroperitoneoscopic procedures.
- Traditional insufflation methods carry risks.
- Direct needle insufflation offers a potential alternative.
Purpose of the Study:
- To assess the feasibility and safety of direct needle insufflation for creating pneumoretroperitoneum.
- To evaluate the anatomical changes facilitating blind needle insertion.
Main Methods:
- Computed tomography (CT) scans analyzed quadratus lumborum-colon (Q-C) distances in supine and lateral positions.
- Prospective collection of operative data from 38 retroperitoneoscopic procedures using direct needle insufflation.
- Veress needle insertion was performed blindly 2 cm above the iliac crest along the posterior axillary line.
Main Results:
- Lateral positioning significantly increased Q-C distance (left: 8.7 to 27.3 mm; right: 4.6 to 18.1 mm, P < 0.05).
- An average lateral Q-C distance of 23 mm was observed.
- One case of Veress needle misplacement occurred (prefascia insufflation), requiring conversion; no visceral or great vessel injuries were reported.
Conclusions:
- Patient repositioning to lateral decubitus significantly increases retroperitoneal space.
- Direct needle insufflation demonstrated a high success rate (97%) and low complication rate in clinical practice.
- This method is considered safe and effective for establishing pneumoretroperitoneum in retroperitoneoscopy.