Veress needle

Veress Needle

A Veress needle used in laparoscopic surgery.

The Veress needle is a medical instrument used for the creation of pneumoperitoneum in laparoscopic surgery. It is named after the Hungarian physician János Veres, who developed the needle in 1938. The Veress needle is a spring-loaded needle that is designed to safely puncture the abdominal wall and introduce carbon dioxide gas into the peritoneal cavity, creating a working space for surgical procedures.

Design and Function

The Veress needle consists of an outer cannula and an inner stylet. The stylet is spring-loaded and retracts into the cannula when pressure is applied, allowing the sharp tip to puncture the abdominal wall. Once the needle is inside the peritoneal cavity, the stylet springs forward, covering the sharp tip and reducing the risk of injury to internal organs. The needle is then used to insufflate the abdomen with carbon dioxide gas, which elevates the abdominal wall and provides a clear view for the surgeon.

Usage in Laparoscopic Surgery

In laparoscopic surgery, the Veress needle is typically inserted at the umbilicus, where the abdominal wall is thinnest. The surgeon makes a small incision and inserts the needle at a 45-degree angle. Once the needle is in place, carbon dioxide is introduced to create pneumoperitoneum. This step is crucial for providing the necessary space to manipulate instruments and visualize the surgical field.

The use of the Veress needle is a standard technique for establishing pneumoperitoneum, although alternative methods, such as the open (Hasson) technique, are also employed depending on the patient's condition and the surgeon's preference.

Complications

While the Veress needle is generally safe, complications can occur. These include injury to internal organs, such as the bowel or blood vessels, and subcutaneous emphysema if the needle is not properly positioned. Proper technique and experience are essential to minimize these risks.

History

The Veress needle was invented by János Veres in 1938. Originally designed for the treatment of tuberculosis by inducing pneumothorax, the needle was later adapted for use in laparoscopic surgery. Its design has remained largely unchanged, and it continues to be a vital tool in minimally invasive surgery.

Related Pages

• Laparoscopic surgery
• Pneumoperitoneum
• János Veres

References

• Soper, N. J., & Brunt, L. M. (1999). "Laparoscopic General Surgery: The Veress Needle." In: Soper, N. J., & Brunt, L. M. (Eds.), Laparoscopic Surgery: Principles and Procedures. Springer.
• Veres, J. (1938). "Neue Methode zur Behandlung des Spontan Pneumothorax." Deutsche Medizinische Wochenschrift.