This video demonstrate laparoscopic access technique using veress needle. The two most common techniques used to gain entry into the peritoneal cavity during laparoscopic general surgery are the blind Veress needle/trocar insertion and open trocar placement under direct visualisation. Once entry to the peritoneal cavity has been achieved, gas insufflation is used to establish pneumoperitoneum and enable visualisation of abdominal structures. Many of the complications associated with operative laparoscopy arise from creation of the pneumoperitoneum, such as subcutaneous emphysema and gas embolism, or from injury to internal structures during abdominal entry.
 

Laparoscopic Access Technique Using Veress Needle at World Laparoscopy Hospital

Laparoscopic surgery has revolutionized modern operative practice by minimizing surgical trauma, reducing postoperative pain, and promoting faster recovery. One of the most critical steps in any laparoscopic procedure is safe and effective abdominal access. At World Laparoscopy Hospital (WLH), the laparoscopic access technique using the Veress needle is taught with precision, safety protocols, and evidence-based methodology, ensuring that surgeons master the foundation of minimal access surgery.

Importance of Safe Laparoscopic Entry

The creation of pneumoperitoneum is the first and most vital step in laparoscopy. Complications during entry, though rare, can be serious if not performed carefully. Therefore, WLH emphasizes a structured, standardized approach to the Veress needle technique. Trainees are taught not only the procedural steps but also the anatomical considerations, patient selection criteria, and strategies to prevent and manage complications.

Step-by-Step Veress Needle Technique at WLH

At World Laparoscopy Hospital, the Veress needle technique is performed following internationally accepted safety guidelines:

1. Patient Positioning and Preparation
   The patient is placed in a supine position. Proper antiseptic preparation and draping are done to maintain sterility. The surgeon ensures that the bladder is emptied to prevent injury.

2. Selection of Entry Site
   The most common site for insertion is the infra-umbilical region, where the abdominal wall is thinnest and relatively avascular. In special cases such as previous abdominal surgeries, alternative sites like Palmer’s point are considered.

3. Abdominal Wall Elevation
   The abdominal wall is lifted manually or using towel clips to increase the distance between the abdominal wall and underlying viscera, minimizing the risk of organ injury.

4. Insertion of Veress Needle
   The Veress needle is introduced at a controlled angle—typically 45 degrees in non-obese patients and 90 degrees in obese patients—while maintaining steady control. Surgeons are trained to feel the characteristic “double click” sensation as the needle passes through the fascia and peritoneum.

5. Confirmation of Correct Placement
   Multiple tests are performed to confirm intraperitoneal placement:

   • Saline drop test

   • Aspiration test

   • Initial low-pressure reading on insufflation

   • Free flow of carbon dioxide

6. Creation of Pneumoperitoneum
   Carbon dioxide is insufflated to achieve adequate intra-abdominal pressure, usually around 12–15 mmHg. Once sufficient pneumoperitoneum is established, the primary trocar is inserted safely.

Training Excellence at WLH

World Laparoscopy Hospital is globally recognized for its structured laparoscopic training programs. Surgeons and gynecologists from around the world receive hands-on training in simulation labs, dry labs, and live operating theaters. The Veress needle technique is practiced repeatedly under expert supervision, allowing participants to build confidence and technical precision.

WLH also emphasizes complication management. Trainees learn how to recognize improper needle placement, subcutaneous emphysema, vascular injury, or bowel injury, and how to respond promptly and effectively. This comprehensive training approach ensures that surgeons are well-prepared for real-world surgical scenarios.

Advantages of the Veress Needle Technique

The Veress needle method offers several advantages:

• Minimally invasive entry

• Reduced incision size

• Lower postoperative pain

• Quick and efficient pneumoperitoneum creation

• Widely applicable in general surgery and gynecology

When performed correctly, it is a safe and reliable method for gaining laparoscopic access.

Conclusion

The laparoscopic access technique using the Veress needle remains a cornerstone of minimal access surgery. At World Laparoscopy Hospital, this technique is taught with a strong emphasis on anatomical knowledge, patient safety, and surgical precision. Through comprehensive training and expert guidance, WLH ensures that surgeons master safe abdominal entry, laying a solid foundation for successful laparoscopic procedures.