Veress needle

Veress Needle

A Veress needle used in laparoscopic surgery

The Veress needle is a medical instrument used in laparoscopic surgery to create a pneumoperitoneum, which is the insufflation of the abdominal cavity with carbon dioxide gas. This procedure is essential for providing the necessary working space for surgeons to perform minimally invasive surgeries.

History

The Veress needle was developed by János Veres, a Hungarian internist, in the 1930s. Originally designed for the treatment of tuberculosis by inducing pneumothorax, the needle was later adapted for use in laparoscopic procedures.

Design

The Veress needle is a spring-loaded needle with a blunt inner stylet that retracts when the needle is pushed against tissue, allowing the sharp outer cannula to penetrate. Once the needle enters the peritoneal cavity, the inner stylet springs forward to protect internal organs from injury.

Usage

In laparoscopic surgery, the Veress needle is inserted through a small incision in the abdominal wall. The surgeon then attaches a gas insufflator to the needle to inflate the abdomen with carbon dioxide. This creates a working space by elevating the abdominal wall away from the internal organs.

Procedure

1. Insertion: The needle is inserted at an angle through the abdominal wall, usually at the umbilicus. 2. Insufflation: Carbon dioxide is introduced to create pneumoperitoneum. 3. Verification: Proper placement is confirmed by checking for free flow of gas and absence of resistance.

Complications

While generally safe, the use of a Veress needle can lead to complications such as:

• Bowel perforation
• Vascular injury
• Subcutaneous emphysema

Proper technique and experience are crucial to minimize these risks.

Alternatives

Alternatives to the Veress needle include the use of an open technique, such as the Hasson technique, which involves a small incision and direct placement of a trocar under direct vision.

Related pages

• Laparoscopy
• Minimally invasive surgery
• Trocar