RESUMO
Introduction: Minimal access surgery has evolved enormously and revolutionised surgical practice. With increasing use of Minimal access surgery, safety of methods of creating Pneumoperitoneum have come under intense scrutiny
Objectives: To observe the effectiveness and intra peritoneal events of using veress needle to create pneumoperitoneum in minimal access surgery. Study design: Prospective observational study. Period: From April to June 2004. Setting: Department of Surgery at Norfolk and Norwich University Hospital
Subject and Methods: 50 patients with male to female ratio 25:1 Veress Needle 14G was inserted infra umbilically through stab incision at angle of 45 degree. BMI [body mass index] and abdominal thickness was recorded. Intra peritoneal events of flow of insufflated air, intraperitoneal position of needle and intraperitoneal adhesions were recorded
Results: [28/50] 56% of patients achieved free flow, [18/50] 36% patients achieved free flow with traction. 44% of patients had free veress needle tip and 44% had tip in omentum, 8% patients showed extra peritoneal air collection. All patients were fit enough to be discharged same day
Discussion: Our study has revealed that body mass index [BMI] and skin fold thickness does not effect the position of needle. With skin fold thickness increase free flow of air needs to be assisted by traction of abdominal wall
Conclusion: We conclude that Veress needle can be safely used for creating pneumoperitoneum in patients of any BMI and skin fold thickness