Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs
PURPOSE: Erroneous punctures and insufflations are frequent with the use of the Veress needle. Mistaken injections of gas in the preperitoneal space are not rare. The purpose of this research is to evaluate the correct positioning of the tip of the needle during creation of pneumoperitoneum. METHODS: The needle was inserted into the peritoneal cavity. Tests to assess the positioning of the needle tip were carried out. Pressure, flow rate and volume were periodically recorded and the needle was removed, being immediately reinserted into the right hypochondrium and placed in the preperitoneal space. RESULTS: The liquid flow test was always positive in the peritoneal cavity. No resistance to saline injection into the peritoneal cavity was observed, but increased resistance to saline injection into the preperitoneal space was observed in 45.5% of the cases. Some saline was recovered in 63.5% of the cases in the peritoneal cavity, and in 54.5% in the preperitoneal space. Saline drop test was positive in 66.6% of the cases in the peritoneal cavity and in 45.5% in the preperitoneal space. In the peritoneal cavity, initial pressure lower than 5 mm Hg was observed, and this pressure gradually increased during 123 seconds until reaching 15 mm Hg. In the preperitoneal space, initial pressure was 15 mm Hg. CONCLUSIONS: Aspiration, liquid flow and saline drop tests are important, whereas recovery test is inconclusive. Initial pressure of approximately 5 mm Hg indicates that the tip of the needle is in the peritoneal cavity. The peritoneal cavity should hold ten times as much volume of gas as the preperitoneal space. The increase in pressure and volume in the peritoneal cavity can be predicted by statistics.
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Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
2006
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oai:scielo:S0102-865020060001000072006-02-13Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigsAzevedo,João Luiz Moreira CoutinhoGuindalini,Rodrigo Santa CruzSorbello,Albino AugustoSilva,Cássio Edvan Paulino daAzevedo,Otávio CansançãoAguiar,Gilmara da SilvaMenezes,Francisco Julimar Correia deDelorenzo,AlinePasqualin,Rubens CampanaKozu,Fábio Okutani Laparoscopy Surgical procedures, operative Pneumoperitoneum, Artificial Punctures Models, Animal PURPOSE: Erroneous punctures and insufflations are frequent with the use of the Veress needle. Mistaken injections of gas in the preperitoneal space are not rare. The purpose of this research is to evaluate the correct positioning of the tip of the needle during creation of pneumoperitoneum. METHODS: The needle was inserted into the peritoneal cavity. Tests to assess the positioning of the needle tip were carried out. Pressure, flow rate and volume were periodically recorded and the needle was removed, being immediately reinserted into the right hypochondrium and placed in the preperitoneal space. RESULTS: The liquid flow test was always positive in the peritoneal cavity. No resistance to saline injection into the peritoneal cavity was observed, but increased resistance to saline injection into the preperitoneal space was observed in 45.5% of the cases. Some saline was recovered in 63.5% of the cases in the peritoneal cavity, and in 54.5% in the preperitoneal space. Saline drop test was positive in 66.6% of the cases in the peritoneal cavity and in 45.5% in the preperitoneal space. In the peritoneal cavity, initial pressure lower than 5 mm Hg was observed, and this pressure gradually increased during 123 seconds until reaching 15 mm Hg. In the preperitoneal space, initial pressure was 15 mm Hg. CONCLUSIONS: Aspiration, liquid flow and saline drop tests are important, whereas recovery test is inconclusive. Initial pressure of approximately 5 mm Hg indicates that the tip of the needle is in the peritoneal cavity. The peritoneal cavity should hold ten times as much volume of gas as the preperitoneal space. The increase in pressure and volume in the peritoneal cavity can be predicted by statistics.info:eu-repo/semantics/openAccessSociedade Brasileira para o Desenvolvimento da Pesquisa em CirurgiaActa Cirúrgica Brasileira v.21 n.1 20062006-02-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502006000100007en10.1590/S0102-86502006000100007 |
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Azevedo,João Luiz Moreira Coutinho Guindalini,Rodrigo Santa Cruz Sorbello,Albino Augusto Silva,Cássio Edvan Paulino da Azevedo,Otávio Cansanção Aguiar,Gilmara da Silva Menezes,Francisco Julimar Correia de Delorenzo,Aline Pasqualin,Rubens Campana Kozu,Fábio Okutani |
spellingShingle |
Azevedo,João Luiz Moreira Coutinho Guindalini,Rodrigo Santa Cruz Sorbello,Albino Augusto Silva,Cássio Edvan Paulino da Azevedo,Otávio Cansanção Aguiar,Gilmara da Silva Menezes,Francisco Julimar Correia de Delorenzo,Aline Pasqualin,Rubens Campana Kozu,Fábio Okutani Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs |
author_facet |
Azevedo,João Luiz Moreira Coutinho Guindalini,Rodrigo Santa Cruz Sorbello,Albino Augusto Silva,Cássio Edvan Paulino da Azevedo,Otávio Cansanção Aguiar,Gilmara da Silva Menezes,Francisco Julimar Correia de Delorenzo,Aline Pasqualin,Rubens Campana Kozu,Fábio Okutani |
author_sort |
Azevedo,João Luiz Moreira Coutinho |
title |
Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs |
title_short |
Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs |
title_full |
Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs |
title_fullStr |
Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs |
title_full_unstemmed |
Evaluation of the positioning of the tip of the Veress needle during creation of closed pneumoperitoneum in pigs |
title_sort |
evaluation of the positioning of the tip of the veress needle during creation of closed pneumoperitoneum in pigs |
description |
PURPOSE: Erroneous punctures and insufflations are frequent with the use of the Veress needle. Mistaken injections of gas in the preperitoneal space are not rare. The purpose of this research is to evaluate the correct positioning of the tip of the needle during creation of pneumoperitoneum. METHODS: The needle was inserted into the peritoneal cavity. Tests to assess the positioning of the needle tip were carried out. Pressure, flow rate and volume were periodically recorded and the needle was removed, being immediately reinserted into the right hypochondrium and placed in the preperitoneal space. RESULTS: The liquid flow test was always positive in the peritoneal cavity. No resistance to saline injection into the peritoneal cavity was observed, but increased resistance to saline injection into the preperitoneal space was observed in 45.5% of the cases. Some saline was recovered in 63.5% of the cases in the peritoneal cavity, and in 54.5% in the preperitoneal space. Saline drop test was positive in 66.6% of the cases in the peritoneal cavity and in 45.5% in the preperitoneal space. In the peritoneal cavity, initial pressure lower than 5 mm Hg was observed, and this pressure gradually increased during 123 seconds until reaching 15 mm Hg. In the preperitoneal space, initial pressure was 15 mm Hg. CONCLUSIONS: Aspiration, liquid flow and saline drop tests are important, whereas recovery test is inconclusive. Initial pressure of approximately 5 mm Hg indicates that the tip of the needle is in the peritoneal cavity. The peritoneal cavity should hold ten times as much volume of gas as the preperitoneal space. The increase in pressure and volume in the peritoneal cavity can be predicted by statistics. |
publisher |
Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia |
publishDate |
2006 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502006000100007 |
work_keys_str_mv |
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