Techniques for the Use of Disposable Veress Needle Puncture

In modern minimally invasive surgery, the use of disposable veress needles is a key step in forming pneumoperitoneum. Correct puncture techniques not only improve the success rate of the surgery but also significantly reduce the occurrence of complications. This article will explore the technical tips for using disposable veress needles, including the selection of puncture position, small tips, and insertion methods, to help medical staff better master this technique.

Technical Tips for Using Disposable Veress Needles

When using disposable veress needles, it is first necessary to understand its basic structure and function. This needle design features a blunt tip to reduce tissue damage. The pneumoperitoneum needle, connected to a carbon dioxide gas cylinder, injects gas into the abdominal cavity to form a pneumoperitoneum. When in use, the needle tip pops out after contacting the skin and applying certain pressure, forming a puncture needle that then penetrates the skin, muscle layer, and serosa to finally reach the abdominal cavity. Upon reaching the abdominal cavity, further insertion must stop immediately to avoid harming the internal organs.

After forming the pneumoperitoneum, the surgeon should observe the degree of abdominal inflation by gently tapping the patient's abdomen. Once the preset pneumoperitoneum pressure is reached, the firstTrocar can be inserted. Correct use of the disposable veress needle is the first step to ensure surgical safety.

Selection of Puncture Position for Disposable Veress Needles

Choosing an appropriate puncture position is critical for the use of disposable veress needles. The selection of the puncture site should consider various factors such as uterine size, surgical scope, abdominal wall thickness, and surgical scars. Here are some common tips for selecting a puncture position:

Uterine surgery

For fallopian tube or ovarian surgery, puncture is usually performed at the navel.

For large uterine removal

During surgery for large adnexal cysts or lymph node dissection, it is recommended to place the puncture site and theTrocar above the navel 4-6cm.

Body type issues

For patients with a shorter stature or shorter distance between the navel and the pubis, it may be necessary to choose an incision above the navel.

Avoiding scars

Try to avoid existing surgical scars to reduce the damage to the bowel adhesions on the abdominal wall.

Tips for Inserting Disposable Veress Needles

When inserting disposable veress needles, there are some small tips that can improve the success rate and safety of the operation:

Disinfection

Before cutting the skin, thoroughly disinfect the navel. Use a small cotton swab dipped in iodine to clean the navel 2-3 times to prevent infection.

Check spring function

Before using the pneumoperitoneum needle, check if the spring of the needle works normally, which is an important preparation step.

Hand force technique

Surgeons with stronger hand strength can use their left hand to lift the abdominal wall directly after cutting the skin and use their right hand to insert the needle into the abdominal cavity.

Lift the abdominal wall

Use towel clips to grasp the skin on both sides of the puncture site, lift it up hard to keep the abdominal wall away from the intestines and omentum, and then make an incision with a small scalpel and insert the pneumoperitoneum needle vertically.

When determining whether the disposable veress needle has entered the abdominal cavity, you can usually confirm by observing the pressure reading on the insufflation device. At the initial stage, the abdominal pressure may be negative. As insufflation progresses, the reading should gradually rise. If the reading rises sharply at the beginning of insufflation, it may indicate that the pneumoperitoneum needle has not completely entered the abdominal cavity.