Video of Veress Needle and Trocar: Essential Access Tools in Laparoscopic Surgery
In this video, we will discuss that Gaining safe and accurate access to the peritoneal cavity is the first critical step in any laparoscopic procedure. The video titled "Veress Needle and Trocar: Essential Access Tools in Laparoscopic Surgery" provides a comprehensive overview of how these two key instruments are used to initiate minimal access surgery. It highlights the technique, safety checks, and best practices necessary for successful entry without complications.
Understanding the Veress Needle
The Veress needle is a spring-loaded, blunt-tipped instrument used to establish pneumoperitoneum—the insufflation of carbon dioxide (CO₂) into the abdominal cavity. This creates the space required for laparoscopic visualization and instrument maneuverability. The needle is inserted, typically at the umbilicus or Palmer’s point, at a specific angle, and its position is confirmed by methods such as:
Saline drop test
Double click sound
Pressure curve analysis on insufflator
Aspiration test to rule out blood or bowel contents
Proper use of the Veress needle minimizes the risk of injury to abdominal organs and ensures uniform gas distribution.
Types of Trocar Systems
After pneumoperitoneum is established, trocars are introduced to provide access ports for the laparoscope and working instruments. Trocars come in various types, including:
Bladed Trocars
Use a sharp cutting tip to pierce the abdominal wall.
Bladeless (Dilating) Trocars
Use a blunt or conical tip that spreads tissue layers rather than cutting, reducing trauma.
Optical Trocars
Allow insertion under direct vision via a camera, offering additional safety in high-risk patients.
Balloon Tipped Trocars
Often used in TEP (totally extraperitoneal) hernia repair to maintain preperitoneal space.
Each trocar includes a cannula and obturator system and often comes with valve seals to maintain pneumoperitoneum during instrument exchange.
Techniques and Safety Measures Highlighted in the Video
Veress needle insertion angle (usually 45° in non-obese patients, 90° in thin patients)
Confirming proper placement before insufflation
Controlled gas flow and intra-abdominal pressure monitoring
Safe trocar insertion with minimal force using twisting motion
Avoiding insertion at previous scar sites to reduce adhesion-related injury
Use of finger or visual guidance in open access (Hasson technique) where applicable
Clinical Importance
Ensures safe entry into the peritoneal cavity
Provides access for camera and instruments
Reduces the risk of intraoperative complications when used correctly
Plays a foundational role in all laparoscopic procedures—from cholecystectomy and appendectomy to TLH and hernia repair
Conclusion
The Veress needle and trocar are more than just tools—they are the gateway to performing safe, effective laparoscopic surgery. Their proper use is essential for establishing access, creating working space, and maintaining pneumoperitoneum throughout the procedure. This video offers practical demonstrations and safety tips that every laparoscopic surgeon must master.
Watch the full video to gain a clear understanding of Veress needle technique, trocar insertion, and the principles of safe abdominal access. Don’t forget to like, comment, and subscribe for more expert surgical content from World Laparoscopy Hospital.
Understanding the Veress Needle
The Veress needle is a spring-loaded, blunt-tipped instrument used to establish pneumoperitoneum—the insufflation of carbon dioxide (CO₂) into the abdominal cavity. This creates the space required for laparoscopic visualization and instrument maneuverability. The needle is inserted, typically at the umbilicus or Palmer’s point, at a specific angle, and its position is confirmed by methods such as:
Saline drop test
Double click sound
Pressure curve analysis on insufflator
Aspiration test to rule out blood or bowel contents
Proper use of the Veress needle minimizes the risk of injury to abdominal organs and ensures uniform gas distribution.
Types of Trocar Systems
After pneumoperitoneum is established, trocars are introduced to provide access ports for the laparoscope and working instruments. Trocars come in various types, including:
Bladed Trocars
Use a sharp cutting tip to pierce the abdominal wall.
Bladeless (Dilating) Trocars
Use a blunt or conical tip that spreads tissue layers rather than cutting, reducing trauma.
Optical Trocars
Allow insertion under direct vision via a camera, offering additional safety in high-risk patients.
Balloon Tipped Trocars
Often used in TEP (totally extraperitoneal) hernia repair to maintain preperitoneal space.
Each trocar includes a cannula and obturator system and often comes with valve seals to maintain pneumoperitoneum during instrument exchange.
Techniques and Safety Measures Highlighted in the Video
Veress needle insertion angle (usually 45° in non-obese patients, 90° in thin patients)
Confirming proper placement before insufflation
Controlled gas flow and intra-abdominal pressure monitoring
Safe trocar insertion with minimal force using twisting motion
Avoiding insertion at previous scar sites to reduce adhesion-related injury
Use of finger or visual guidance in open access (Hasson technique) where applicable
Clinical Importance
Ensures safe entry into the peritoneal cavity
Provides access for camera and instruments
Reduces the risk of intraoperative complications when used correctly
Plays a foundational role in all laparoscopic procedures—from cholecystectomy and appendectomy to TLH and hernia repair
Conclusion
The Veress needle and trocar are more than just tools—they are the gateway to performing safe, effective laparoscopic surgery. Their proper use is essential for establishing access, creating working space, and maintaining pneumoperitoneum throughout the procedure. This video offers practical demonstrations and safety tips that every laparoscopic surgeon must master.
Watch the full video to gain a clear understanding of Veress needle technique, trocar insertion, and the principles of safe abdominal access. Don’t forget to like, comment, and subscribe for more expert surgical content from World Laparoscopy Hospital.
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