Intraperitoneal Pressure and Volume of Gas Injected as Effective Parameters of the Correct Position of the Veress Needle During Creation of Pneumoperitoneum

Azevedo, João Luiz Moreira Coutinho; Azevedo, Otávio Cansanção; Sorbello, Albino Augusto; Becker, Otávio Monteiro; Hypolito, Otavio; Freire, Dalmer Faria; Miyahira, Susana Abe; Guedes, Afonso; Azevedo, Glicia C.

doi:10.1089/lap.2009.0080

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…It has been established that intraperitoneal pressure levels and the total volume of gas insufflated into the peritoneal cavity at given time points can be predicted, provided that the tip of the Verres needle is in fact in the peritoneal cavity during insufflation [36]. …”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Entry Methods for Laparoscopic Port Entry: Technical Point of VIEW

Toro

Mannino

Cappello

et al. 2012

Diagnostic and Therapeutic Endoscopy

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Laparoscopic entry is a blind procedure and it often represents a problem for all the related complications. In the last three decades, rapid advances in laparoscopic surgery have made it an invaluable part of general surgery, but there remains no clear consensus on an optimal method of entry into the peritoneal cavity. The aim of this paper is to focus on the evolution of two used methods of entry into the peritoneal cavity in laparoscopic surgery.

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Section: Discussionmentioning

confidence: 99%

Comparison of Two Entry Methods for Laparoscopic Port Entry: Technical Point of VIEW

Toro

Mannino

Cappello

et al. 2012

Diagnostic and Therapeutic Endoscopy

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“…Thus, the improvement in identification methods of the needle position and injuries by the test of confirmation after puncture and during the pneumoperitoneum establishment becomes of capital importance 20 . It is also useful to adopt parameters of volume of gas injected into each moment and resultant intraperitoneal pressure during inflation to ensure the correct location of the gas inside the cavity peritoneal 21 . It was also demonstrated that the development of pneumoperitoneum runs as well with the alternative puncture in the left hypochondrium as with the classic one, in the abdomen midline 17 .…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…Nonetheless, for the left hypochondrium puncture one must take into account the risk of injury to the superior epigastric vessels and structures immediately posterior to the anterior abdominal wall at the puncture site, such as the gastric body, transverse colon and greater omentum. However, the trunks and branches of larger caliber of the superior epigastric vessels never lie at a distance greater than eight centimeters from the midline of the abdomen, so punctures beyond that distance prevent lesions of those vessels [21][22][23] . The values of tests and parameters established to assess the safety in the development of pneumoperitoneum has been shown by Azevedo [16][17][18] in patients without previous abdominal surgeries, previous intra-abdominal inflammatory conditions and with a BMI below 30.…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Punção com agulha de Veress no hipocôndrio esquerdo para a criação do pneumoperitônio: valor diagnóstico das provas de posicionamento da agulha em pacientes não selecionados

Becker

Azevedo

Azevedo³

et al. 2011

Rev. Col. Bras. Cir.

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Veress needle insertion into the left hypochondrium for creation of pneumoperitoneum: diagnostic value of tests to determine the position of the needle in unselected patients Original Article Original Article Original Article Original Article Original Article Veress needle insertion into the left hypochondrium for creation Veress needle insertion into the left hypochondrium for creation Veress needle insertion into the left hypochondrium for creation Veress needle insertion into the left hypochondrium for creation Veress needle insertion into the left hypochondrium for creation of pneumoperitoneum: diagnostic value of tests to determine the of pneumoperitoneum: diagnostic value of tests to determine the of pneumoperitoneum: diagnostic value of tests to determine the of pneumoperitoneum: diagnostic value of tests to determine the of pneumoperitoneum: diagnostic value of tests to determine the position of the needle in unselected patients position of the needle in unselected patients position of the needle in unselected patients position of the needle in unselected patients position of the needle in unselected patients Punção com agulha de Veress no hipocôndrio esquerdo para a criação do Punção com agulha de Veress no hipocôndrio esquerdo para a criação do Punção com agulha de Veress no hipocôndrio esquerdo para a criação do Punção com agulha de Veress no hipocôndrio esquerdo para a criação do Punção com agulha de Veress no hipocôndrio esquerdo para a criação do pneumoperitônio: valor diagnóstico das provas de posicionamento da agulha em pneumoperitônio: valor diagnóstico das provas de posicionamento da agulha em pneumoperitônio: valor diagnóstico das provas de posicionamento da agulha em pneumoperitônio: valor diagnóstico das provas de posicionamento da agulha em pneumoperitônio: valor diagnóstico das provas de posicionamento da agulha em pacientes não selecionados pacientes não selecionados pacientes não selecionados pacientes não selecionados pacientes não selecionados OTÁVIO To assess the effectiveness of the Veress needle puncture in the left hypochondrium and the accuracy of the tests described for the intraperitoneal correct positioning of the tip of the Veress needle in an unselected population. Methods:Methods: Methods: Methods: Methods: Ninetyone patients consecutively scheduled for Videolaparoscopy had the abdominal wall punctured in the left hypochondrium. There were no exclusion criteria. The patients received general anesthesia and mechanical ventilation according to the protocol. After puncturing five tests were used to confirm the positioning of the needle tip within the peritoneal cavity: aspiration test -AT; resistance to infusion -Pres; recovery of the infused fluid -Prec, dripping test -DT, and test of initial intraperitoneal pressure -IIPP. The test results were compared with results from literature for groups with defined exclusion criteria. The results were used for calculating sensitivity (S) specificity (E), positive predictive value (PPV) and negative predictive value (NPV). Inferential...

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“…In addition, analysis of intraperitoneal pressure and volume of gas insufflated at different time points during insufflation is essential to prevent gas insufflation into sites other than the peritoneal cavity. It has been established that intraperitoneal pressure levels and the total volume of gas insufflated into the peritoneal cavity at given time points can be predicted, provided that the tip of the Veress needle is in fact in the peritoneal cavity during insufflation [11]. Therefore, incidence of iatrogenic injury during Veress needle insertion for creation of pneumoperitoneum can be reduced by performing tests and analyzing intraperitoneal pressure and gas volume during insufflation.…”

mentioning

confidence: 99%

Creation of pneumoperitoneum: noninvasive monitoring of clinical effects of elevated intraperitoneal pressure for the insertion of the first trocar

et al. 2009

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Transitory, high intraperitoneal pressure (20 mmHg for 5 min) for insertion of the first trocar resulted in changes in HR, MAP, ETCO(2), and ITP that were within the normal range, and no adverse clinical effects were observed. Therefore, the use of transitory, high intraperitoneal pressure is recommended to prevent iatrogenic injury during blind insertion of the first trocar. Nevertheless, it is not clear that this method would be safe in patients with moderate to severe chronic obstructive pulmonary disease.

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Intraperitoneal Pressure and Volume of Gas Injected as Effective Parameters of the Correct Position of the Veress Needle During Creation of Pneumoperitoneum

Abstract: Values of IP and VG at given time points during insufflation for creation of the pneumoperitoneum, using the Veress needle, can be effective parameters to determine whether the needle is correctly positioned in the peritoneal cavity.

Cited by 3 publications

References 16 publications

Comparison of Two Entry Methods for Laparoscopic Port Entry: Technical Point of VIEW

Comparison of Two Entry Methods for Laparoscopic Port Entry: Technical Point of VIEW

Punção com agulha de Veress no hipocôndrio esquerdo para a criação do pneumoperitônio: valor diagnóstico das provas de posicionamento da agulha em pacientes não selecionados

Creation of pneumoperitoneum: noninvasive monitoring of clinical effects of elevated intraperitoneal pressure for the insertion of the first trocar

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