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Direct Trocar Insertion versus Veress Needle Insertion Technique for Creating Pneumoperitoneum in Laparoscopic Surgeries: A Prospective Interventional Study |
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Prashanth Pawan Kalal, Bhavuray Teli, C Shobha, Ashok S Mallapur, Aniketh Mallapur 1. Resident Doctor, Department of General Surgery, SNMC and HSK Hospital, Navanagar, Bagalkot, Karnataka, India. 2. Professor, Department of General Surgery, SNMC and HSK Hospital, Navanagar, Bagalkot, Karnataka, India. 3. Associate Professor, Department of General Surgery, SNMC and HSK Hospital, Navanagar, Bagalkot, Karnataka, India. 4. Professor, Department of General Surgery, SNMC and HSK Hospital, Navanagar, Bagalkot, Karnataka, India. 5. Senior Resident, Department of General Surgery, SNMC and HSK Hospital, Navanagar, Bagalkot, Karnataka, India. |
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Correspondence Address : Dr. Prashanth Pawan Kalal, Department of General Surgery, S. Nijalingappa Medical College and HSK Hospital, Navanagar, Bagalkot-587102, Karnataka, India. E-mail: prashanthppk1996@gmail.com |
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| ABSTRACT |  | ||||||
: Introduction: The creation of pneumoperitoneum is an indispensable first step in laparoscopy, as it allows for the establishment of an operative field. There is ambiguity regarding the efficacy and complications of different techniques used for creating pneumoperitoneum. Aim: To evaluate the safety and efficacy of creating pneumoperitoneum in laparoscopic surgeries with respect to direct safety trocar insertion and Veress needle insertion. Materials and Methods: This prospective interventional study was conducted with 70 subjects undergoing laparoscopic surgeries at the Department of General Surgery, Shree Nijalingappa Medical College, and HSK Hospital and Research Centre, Bagalkot, Karnataka, India. Study subjects were allocated into two groups: direct trocar insertion group (Group A; n=35) and Veress needle insertion group (Group B; n=35). The variables measured included the number of attempts, time taken to create pneumoperitoneum, incidence of gas leakage, incidence of extraperitoneal insufflation, incidence of minor vessel injury, incidence of major vessel injury, incidence of bowel injury, and incidence of port site infection. An independent t-test was used to compare continuous variables between the study groups, while a Chi-square test was utilised to compare categorical variables. Results: The mean time taken to create pneumoperitoneum (in seconds) was significantly less in the direct trocar insertion group (93.71±22.81 seconds) compared with the Veress needle insertion group (197.43±22.83 seconds). The mean number of attempts required to create pneumoperitoneum was similar, with one attempt in both groups. There was no significant difference in intraoperative complications such as gas leakage (p-value=1.000) and extraperitoneal insufflation (p-value=0.24) between the groups. Furthermore, there were no major or minor vessel injuries or bowel injuries observed in either group. Additionally, no significant port-site infections were noted in either of the groups. Conclusion: Direct trocar insertion and Veress needle insertion techniques are equally effective and safe for creating pneumoperitoneum. However, the direct trocar insertion technique allows for quicker creation. | |||||||
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| Keywords : Gas leakage, Laparoscopic complications, Minor vessel injury, Port-site infection | |||||||
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DOI and Others :
DOI: 10.7860/IJARS/2025/75069.3059
Date of Submission: Aug 24, 2024 Date of Peer Review: Oct 25, 2024 Date of Acceptance: Dec 05, 2024 Date of Publishing: Jul 01, 2025 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was Ethics Committee Approval obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. NA PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Aug 25, 2024 • Manual Googling: Nov 29, 2024 • iThenticate Software: Dec 04, 2024 (16%) ETYMOLOGY: Author Origin EMENDATIONS: 6 |
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