Veress needle
Encyclopedia
A Veress needle is a spring-loaded needle used to create pneumoperitoneum
for laparoscopic surgery
. Of the three general approaches to laparoscopic access, the Veress needle technique is the oldest and most traditional.
patients. At the time, one of the mainstays of treatment was to collapse an infected lung and allow lesions to heal. The needle was introduced as a safer technique to give patients such pneumothoraces. It was not until 1938, when he published his invention in the German
literature, that the needle became more broadly known outside of Hungary.
of 2 mm. The outer cannula
consists of a beveled needle point for cutting through tissues of the abdominal wall. A spring-loaded, inner stylet is positioned within the outer cannula. This inner stylet has a dull tip to protect any viscera from injury by the sharp, outer cannula. Direct pressure on the tip—as when penetrating through tissue—pushes the dull stylet into the shaft of the outer cannula. When the tip of the needle enters a space such as the peritoneal cavity
, the dull, inner stylet springs forward. Carbon dioxide
is then passed through the Veress needle to inflate the space, creating a pneumoperitoneum
.
procedures, the Veress needle technique was used in 78% of them. Gynecologists (81%) used the tool more often than general surgeons (48%) who are far more likely to use the open access technique.
Pneumoperitoneum
Pneumoperitoneum is air or gas in the abdominal cavity. It is often seen on X-ray, but small amounts are often missed, and CT is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum. CT can visualize quantities as small as 5 cm³ of air or gas...
for laparoscopic surgery
Laparoscopic surgery
Laparoscopic surgery, also called minimally invasive surgery , bandaid surgery, or keyhole surgery, is a modern surgical technique in which operations in the abdomen are performed through small incisions as opposed to the larger incisions needed in laparotomy.Keyhole surgery makes use of images...
. Of the three general approaches to laparoscopic access, the Veress needle technique is the oldest and most traditional.
History
The tool was first developed in 1932 by Janos Veress, a Hungarian internist working with tuberculosisTuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
patients. At the time, one of the mainstays of treatment was to collapse an infected lung and allow lesions to heal. The needle was introduced as a safer technique to give patients such pneumothoraces. It was not until 1938, when he published his invention in the German
German language
German is a West Germanic language, related to and classified alongside English and Dutch. With an estimated 90 – 98 million native speakers, German is one of the world's major languages and is the most widely-spoken first language in the European Union....
literature, that the needle became more broadly known outside of Hungary.
Description
Modern needles are 12 to 15 cm long, with an external diameterDiameter
In geometry, a diameter of a circle is any straight line segment that passes through the center of the circle and whose endpoints are on the circle. The diameters are the longest chords of the circle...
of 2 mm. The outer cannula
Cannula
A cannula or canula is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of data...
consists of a beveled needle point for cutting through tissues of the abdominal wall. A spring-loaded, inner stylet is positioned within the outer cannula. This inner stylet has a dull tip to protect any viscera from injury by the sharp, outer cannula. Direct pressure on the tip—as when penetrating through tissue—pushes the dull stylet into the shaft of the outer cannula. When the tip of the needle enters a space such as the peritoneal cavity
Peritoneal cavity
The peritoneal cavity is a potential space between the parietal peritoneum and visceral peritoneum, that is, the two membranes that separate the organs in the abdominal cavity from the abdominal wall...
, the dull, inner stylet springs forward. Carbon dioxide
Carbon dioxide
Carbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...
is then passed through the Veress needle to inflate the space, creating a pneumoperitoneum
Pneumoperitoneum
Pneumoperitoneum is air or gas in the abdominal cavity. It is often seen on X-ray, but small amounts are often missed, and CT is nowadays regarded as a criterion standard in the assessment of a pneumoperitoneum. CT can visualize quantities as small as 5 cm³ of air or gas...
.
Use
In a large survey of 155,987 gynecologic procedures and 17,216 general surgeryGeneral surgery
General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g., intestines including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland . They also deal with diseases involving the skin, breast, soft...
procedures, the Veress needle technique was used in 78% of them. Gynecologists (81%) used the tool more often than general surgeons (48%) who are far more likely to use the open access technique.