Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs

Azevedo, João Luiz Moreira Coutinho; Guindalini, Rodrigo Santa Cruz; Sorbello, Albino Augusto; Silva, Cássio Edvan Paulino da; Azevedo, Otávio Cansanção; Aguiar, Gilmara da Silva; Delorenzo, Aline; Pasqualin, Rubens Campana; Kozu, Fábio Okutani

doi:10.1590/s0102-86502006000100007

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…So it is important to use specific tests, like aspiration, injection, and hanging drop, and to check the insufflation pressure to confirm needle placement in the peritoneal cavity. In our experience, correct intercostal insertion should be accompanied by a clear double “click” or “2 pops” when the VN reaches the peritoneal cavity. This results from the different tissue layers crossed (the 1st click occurs when the muscular fascia is penetrated and the 2nd when the peritoneum is penetrated) and the direction of the needle, as reported in people.…”

Section: Discussionmentioning

confidence: 99%

Right Intercostal Insertion of a Veress Needle for Laparoscopy in Dogs

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Right Intercostal Insertion of a Veress Needle for Laparoscopy in Dogs

et al. 2012

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“…Argarwala et al reported some complications with intercostal VN insertion in 504 of 918 patients, but only 2 injuries (0.39%) were caused by VN placement. In pigs, left subcostal entry of the VN, 3 cm from the midline allowed the VN to be placed safely into the peritoneal cavity, without injury to underlying organs …”

Section: Discussionmentioning

confidence: 99%

“…After insertion of the VN, its peritoneal location was verified with an aspiration test, an injection/recovery test, and a saline drop test . If the VN was inserted into the subcutaneous tissue, the insertion was scored as a failed attempt and the VN was withdrawn.…”

Section: Methodsmentioning

confidence: 99%

Intercostal Insertion of Veress Needle for Canine Laparoscopic Procedures: A Cadaver Study

Doerner

Fiorbianco²,

Dupré

2012

Veterinary Surgery

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“…The tests performed to check whether the Veress needle is correctly positioned (closed technique) lack objective criteria of validation. Researches on this topic are found in the literature, but they involve laboratory animals 13 , not humans. Injection, recovery, saline drop and initial intraperitoneal pressure tests were performed to detect whether the tip of the needle was inside the peritoneal cavity.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of tests performed to confirm the position of the Veress needle for creation of pneumoperitoneum in selected patients: a prospective clinical trial

Azevedo

Sorbello³

et al. 2006

Acta Cir. Bras.

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PURPOSE: To evaluate tests performed to confirm the position of the Veress needle inserted into the left hypochondrium for creation of pneumoperitonium. METHODS: One hundred patients were submitted to laparoscopic procedure with left hypochondrium puncturing. Needle positioning tests were evaluated. The aspiration test was considered positive when organic material was aspirated; the injection test was considered positive when no increased resistance to liquid injection was observed; the recovery test was considered positive when the liquid injected was not recovered; the saline drop test was considered positive when drops of saline in the syringe disappeared quickly; the initial intraperitoneal pressure test was considered positive when pressure levels were £ 8 mmHg. A positive aspiration test indicated iatrogenic injury, whereas a positive result in any of the other tests indicated that the tip of the needle was correctly positioned in the peritoneal cavity. Sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) of the tests were calculated by correlating results considered true positives (a), false positives (b), false negatives (c) and true negatives (d), according to the formulas: SE = [a/(a + c)] x 100; SP = [d/(b + d)] x 100; PPV = [a/(a + b)] x 100; NPV = [d(c + d)] x 100. RESULTS: With regard to the aspiration test, SE and PPV were not applicable, SP was 100% and NPV was 100%. With regard to the injection test, SE was 0%, SP was 100%, PPV was inexistent and NPV was 90%. Both recovery and saline drop tests yielded the following results: SE was 50%, SP was 100%, PPV was 100% and NPV was 94.7%. The initial intraperitoneal pressure test yielded the following results: SE, SP, PPV and NPV were 100%. CONCLUSIONS: When inserting the Veress needle into the left hypochondrium, a negative aspiration test guarantees the absence of iatrogenic injury; the injection test is not reliable to determine incorrect needle positioning, but it accurately detects correct needle positioning; recovery and saline drop tests are not reliable to determine correct needle positioning, but they accurately detect incorrect needle positioning; the initial intraperitoneal pressure test is reliable to determine both correct and incorrect needle positioning, and proved to be the most reliable of the tests analyzed.

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Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs

Cited by 7 publications

References 14 publications

Right Intercostal Insertion of a Veress Needle for Laparoscopy in Dogs

Right Intercostal Insertion of a Veress Needle for Laparoscopy in Dogs

Intercostal Insertion of Veress Needle for Canine Laparoscopic Procedures: A Cadaver Study

Evaluation of tests performed to confirm the position of the Veress needle for creation of pneumoperitoneum in selected patients: a prospective clinical trial

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