Laparoscopic Bowel and Vascular Complications: Should the Veress Needle and Cannula Be Replaced?

We undertook a retrospective survey of bowel and vascular complications in gynecologic laparoscopic surgery reported to the three major medical defense organizations in this state between January 1988 and September 1993. Twenty-six bowel injuries and eight vascular complications were reported. The majority of these patients had undergone either diagnostic laparoscopy or laparoscopic tubal ligation. The majority of injuries were attributed to the Veress needle in creating primary pneumoperitoneum or inserting the primary cannula. Three of the 26 bowel injuries and 3 of 8 vascular injuries resulted in death. Laparoscopic bowel and vascular injuries can thus be related to the Veress needle or the primary cannula. The serious sequelae suggest a need to assess the current methods of establishing pneumoperitoneum for laparoscopy.