Veress needle versus direct trocar insertion techniques for inducing pneumoperitoneum in laparoscopic procedures

ABSTRACT

To compare the safety and complications of veress needle [VN] versus direct trocar insertion [DTI] techniques in laparoscopic procedures. Comparative study. The study was conducted at three different hospitals in Karachi from October 2005 to May 2011. A total of 1050 consecutive laparoscopic surgeries were done during the study period. Female to male ratio was 2.51. In 73% of the cases direct trocar placement was done while in 27% pneumoperitoneum was achieved with Veress needle. Variables noted included technique, complications, and duration of surgery. Data was analyzed statistically using SPSS version 16. Female to male ratio was 2.51.Complications were more in direct trocar insertion method. Overall total complications were 3.4%. One percent in group I [VN technique] and 4% in group II [DTI technique] had complications [p=0.017]. No visceral injuries were noted in either group, but pre-peritoneal insufflations found in 2 patients [0.25%] in group II. Late complications were more in group II. This include wound infection [1.5%], late wound bleeding [0.9%], port site hernia formation [0.9%] and chronic sinus formation [0.38%].All these were statistically insignificant except wound infection [p 0.036]. Veress needle method is as safe as direct trocar insertion method in expert hands