Working Principle and Clinical Application of Pneumoperitoneum Needle

The working principle of the pneumoperitoneum needle

The pneumoperitoneum needle has a spring protection device inside. When puncturing the abdominal wall, the needle core retracts into the needle sheath due to resistance, and the pointed end of the needle sheath can pierce the abdominal wall. When the needle sheath punctures the peritoneum and enters the abdominal cavity, the resistance disappears and the needle core pops out of the needle sheath under the action of the spring, making the front end of the pneumoperitoneum needle blunt to avoid damaging the organs in the abdominal cavity. However, it should be noted that the pneumoperitoneum needle will lose its protective function when there are adhesions in the peritoneal cavity.

Clinical applications of the pneumoperitoneum needle

It is clinically used to puncture the abdominal cavity for chemotherapy, perform simple thoracentesis, and tie the hernia sac in the inguinal region under laparoscopy with a wire-reinforced pneumoperitoneum needle. It has the advantages of small trauma, hidden incision, fast recovery, short hospital stay, simple operation, and precise curative effect. It can also discover contralateral hidden hernia and avoid secondary surgery. The application of the pneumoperitoneum needle to hang the appendix with a suture and perform appendectomy with a double-port laparoscope is simple, economical and practical.

Method of placing the pneumoperitoneum needle

A small tip on placing the pneumoperitoneum needle: Before determining the puncture site and preparing to cut the skin, don't forget to disinfect the belly button. Ignoring this step may result in a belly button incision that is difficult to heal, and even infection and suppuration, which is too costly. It is best to use a cotton swab dipped in iodophor to clean the belly button 2-3 times and carefully remove the accumulated dirt. After getting the pneumoperitoneum needle, an important action is to check whether the spring of the abdominal insufflation needle is working properly, and make it a habit.

A small method for placing the abdominal insufflation needle: For those with strong hands, they can directly use their left hand to grasp the abdominal wall after cutting the skin and insert the needle into the abdominal cavity with their right hand. The commonly used method is to use two towel clamps to hold the skin on both sides of the puncture site and lift it upward forcefully, making the abdominal wall away from the intestine and omentum. Then, use a small scalpel to make an 8-10mm incision at the puncture site. The main surgeon lifts the towel clamp with the left hand, holds the handle of the abdominal insufflation needle with a pen grip (brush), supports the wrist against the abdominal wall, and slowly inserts the abdominal insufflation needle vertically into the abdominal cavity. During the insertion process, there are usually two breakthrough feelings, which occur when the pneumoperitoneum needle passes through the fascia and the peritoneum of the abdominal wall. If the peritoneum is soft and poorly elastic, the second breakthrough feeling is often not obvious.