Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review
Background The aim of this study was to assess the prevalence, risks, and outcomes of injuries caused by the Veress needle described in the literature. Methods Iatrogenic injuries caused by Veress needle insertion during diagnostic or therapeutic laparoscopies in humans were researched, with no lang...
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| Veröffentlicht in: | Surgical endoscopy 2009-07, Vol.23 (7), p.1428-1432 |
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| creator | Azevedo, João Luiz Moreira Coutinho Azevedo, Otavio Cansanção Miyahira, Susana Abe Miguel, Gustavo Peixoto Soares Becker, Otávio Monteiro Hypólito, Octávio Henrique Mendes Machado, Afonso Cesar Cabral Guedes Cardia, Wellington Yamaguchi, Gilmara Aguiar Godinho, Lola Freire, Dalmer Almeida, Carlos Eduardo Saldanha Moreira, Camila Hobi Freire, Dalmer Faria |
| description | Background
The aim of this study was to assess the prevalence, risks, and outcomes of injuries caused by the Veress needle described in the literature.
Methods
Iatrogenic injuries caused by Veress needle insertion during diagnostic or therapeutic laparoscopies in humans were researched, with no language restriction, in the Medline, Lilacs, Embase, Scielo, and Cochrane Library databases. The following words were combined: “Veress” or “insufflation needle” or “pneumoperitoneum needle,” and “complications” or “injuries” or “lesions.” The bibliographic references of the selected articles were also analyzed. We considered the following: (1) number of injuries described in the literature, (2) relationship between number of injuries and number of patients who underwent Veress needle insertion in the studies that reported Veress needle injury, (3) organs and structures injured (retroperitoneal vessels, digestive tract, and self-limited, minor injuries), and (4) outcome (death, conversion to laparotomy, laparoscopic repair, spontaneous resolution).
Results
Thirty-eight selected articles included 696,502 laparoscopies, with 1,575 injuries (0.23%), 126 (8%) of which involved blood vessels or hollow viscera (0.018% of all laparoscopies). Of the 98 vascular injuries, 8 (8.1%) were injuries to major retroperitoneal vessels. There were 34 other reported retroperitoneal injuries, but the authors were not specific as to which vessel was injured. Of the 28 injuries to hollow viscera, 17 were considered major injuries, i.e., 60.7% (0.0024% of the total cases assessed).
Conclusion
The insertion of the Veress needle in the abdominal midline, at the umbilicus, poses serious risk to the life of patients. Therefore, further studies should be conducted to investigate alternative sites for Veress needle insertion. |
| doi_str_mv | 10.1007/s00464-009-0383-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67378143</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67378143</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-96184e9fd153a7103fd468e41a9dc7bea94872ec3bf69fe49cf6a5f63d3290ea3</originalsourceid><addsrcrecordid>eNp10U2LFDEQBuAgiju7-gO8SBD01pqv7iTeZNF1YcGLeg2ZdEUydidjqluZf2_GGVwQPCUhTyVFvYQ84-w1Z0y_QcbUoDrGbMekkZ19QDZcSdEJwc1DsmFWsk5oqy7IJeKONW55_5hccCsGyYXakO-3ebfWBEiDXxFGuj3Qr1ABkWaAcQKaMkJdUsk0lkpDBf_nUCLdZ1jnsoealnLcvqWe4gEXmBsJdEoLVL-sFWiFnwl-PSGPop8Qnp7XK_Llw_vP1x-7u083t9fv7rogrV06O3CjwMaR99JrzmQc1WBAcW_HoLfgrTJaQJDbONgIyoY4-D4OcpTCMvDyirw6vbuv5ccKuLg5YYBp8hnKim7QUps2pwZf_AN3Za259eYEt6rX1uiG-AmFWhArRLevafb14DhzxxjcKQbXYnDHGJxtNc_PD6_bGcb7ivPcG3h5Bh6Dn2L1OST86wTXwrDeNCdODttV_gb1vsP___4bLFGhVA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>219457987</pqid></control><display><type>article</type><title>Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Azevedo, João Luiz Moreira Coutinho ; Azevedo, Otavio Cansanção ; Miyahira, Susana Abe ; Miguel, Gustavo Peixoto Soares ; Becker, Otávio Monteiro ; Hypólito, Octávio Henrique Mendes ; Machado, Afonso Cesar Cabral Guedes ; Cardia, Wellington ; Yamaguchi, Gilmara Aguiar ; Godinho, Lola ; Freire, Dalmer ; Almeida, Carlos Eduardo Saldanha ; Moreira, Camila Hobi ; Freire, Dalmer Faria</creator><creatorcontrib>Azevedo, João Luiz Moreira Coutinho ; Azevedo, Otavio Cansanção ; Miyahira, Susana Abe ; Miguel, Gustavo Peixoto Soares ; Becker, Otávio Monteiro ; Hypólito, Octávio Henrique Mendes ; Machado, Afonso Cesar Cabral Guedes ; Cardia, Wellington ; Yamaguchi, Gilmara Aguiar ; Godinho, Lola ; Freire, Dalmer ; Almeida, Carlos Eduardo Saldanha ; Moreira, Camila Hobi ; Freire, Dalmer Faria</creatorcontrib><description>Background
The aim of this study was to assess the prevalence, risks, and outcomes of injuries caused by the Veress needle described in the literature.
Methods
Iatrogenic injuries caused by Veress needle insertion during diagnostic or therapeutic laparoscopies in humans were researched, with no language restriction, in the Medline, Lilacs, Embase, Scielo, and Cochrane Library databases. The following words were combined: “Veress” or “insufflation needle” or “pneumoperitoneum needle,” and “complications” or “injuries” or “lesions.” The bibliographic references of the selected articles were also analyzed. We considered the following: (1) number of injuries described in the literature, (2) relationship between number of injuries and number of patients who underwent Veress needle insertion in the studies that reported Veress needle injury, (3) organs and structures injured (retroperitoneal vessels, digestive tract, and self-limited, minor injuries), and (4) outcome (death, conversion to laparotomy, laparoscopic repair, spontaneous resolution).
Results
Thirty-eight selected articles included 696,502 laparoscopies, with 1,575 injuries (0.23%), 126 (8%) of which involved blood vessels or hollow viscera (0.018% of all laparoscopies). Of the 98 vascular injuries, 8 (8.1%) were injuries to major retroperitoneal vessels. There were 34 other reported retroperitoneal injuries, but the authors were not specific as to which vessel was injured. Of the 28 injuries to hollow viscera, 17 were considered major injuries, i.e., 60.7% (0.0024% of the total cases assessed).
Conclusion
The insertion of the Veress needle in the abdominal midline, at the umbilicus, poses serious risk to the life of patients. Therefore, further studies should be conducted to investigate alternative sites for Veress needle insertion.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-009-0383-9</identifier><identifier>PMID: 19263124</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdomen ; Abdominal Surgery ; Biological and medical sciences ; Blood Vessels - injuries ; Digestive system. Abdomen ; Embolism, Air - etiology ; Endoscopy ; Equipment Design ; Female ; Fetal Death - etiology ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal Tract - injuries ; General aspects ; Gynecology ; Hemorrhage - etiology ; Hemorrhage - mortality ; Hepatology ; Humans ; Insufflation - instrumentation ; Intraoperative Complications - epidemiology ; Intraoperative Complications - etiology ; Intraoperative Complications - surgery ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopy ; Laparotomy ; Literature reviews ; Medical sciences ; Medicine ; Medicine & Public Health ; Needles - adverse effects ; Other diseases. Semiology ; Peritonitis - etiology ; Pneumoperitoneum, Artificial - instrumentation ; Pregnancy ; Prevalence ; Proctology ; Punctures - adverse effects ; Review ; Surgery ; Urinary Bladder - injuries</subject><ispartof>Surgical endoscopy, 2009-07, Vol.23 (7), p.1428-1432</ispartof><rights>Springer Science+Business Media, LLC 2009</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-96184e9fd153a7103fd468e41a9dc7bea94872ec3bf69fe49cf6a5f63d3290ea3</citedby><cites>FETCH-LOGICAL-c399t-96184e9fd153a7103fd468e41a9dc7bea94872ec3bf69fe49cf6a5f63d3290ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-009-0383-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-009-0383-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21728058$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19263124$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Azevedo, João Luiz Moreira Coutinho</creatorcontrib><creatorcontrib>Azevedo, Otavio Cansanção</creatorcontrib><creatorcontrib>Miyahira, Susana Abe</creatorcontrib><creatorcontrib>Miguel, Gustavo Peixoto Soares</creatorcontrib><creatorcontrib>Becker, Otávio Monteiro</creatorcontrib><creatorcontrib>Hypólito, Octávio Henrique Mendes</creatorcontrib><creatorcontrib>Machado, Afonso Cesar Cabral Guedes</creatorcontrib><creatorcontrib>Cardia, Wellington</creatorcontrib><creatorcontrib>Yamaguchi, Gilmara Aguiar</creatorcontrib><creatorcontrib>Godinho, Lola</creatorcontrib><creatorcontrib>Freire, Dalmer</creatorcontrib><creatorcontrib>Almeida, Carlos Eduardo Saldanha</creatorcontrib><creatorcontrib>Moreira, Camila Hobi</creatorcontrib><creatorcontrib>Freire, Dalmer Faria</creatorcontrib><title>Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
The aim of this study was to assess the prevalence, risks, and outcomes of injuries caused by the Veress needle described in the literature.
Methods
Iatrogenic injuries caused by Veress needle insertion during diagnostic or therapeutic laparoscopies in humans were researched, with no language restriction, in the Medline, Lilacs, Embase, Scielo, and Cochrane Library databases. The following words were combined: “Veress” or “insufflation needle” or “pneumoperitoneum needle,” and “complications” or “injuries” or “lesions.” The bibliographic references of the selected articles were also analyzed. We considered the following: (1) number of injuries described in the literature, (2) relationship between number of injuries and number of patients who underwent Veress needle insertion in the studies that reported Veress needle injury, (3) organs and structures injured (retroperitoneal vessels, digestive tract, and self-limited, minor injuries), and (4) outcome (death, conversion to laparotomy, laparoscopic repair, spontaneous resolution).
Results
Thirty-eight selected articles included 696,502 laparoscopies, with 1,575 injuries (0.23%), 126 (8%) of which involved blood vessels or hollow viscera (0.018% of all laparoscopies). Of the 98 vascular injuries, 8 (8.1%) were injuries to major retroperitoneal vessels. There were 34 other reported retroperitoneal injuries, but the authors were not specific as to which vessel was injured. Of the 28 injuries to hollow viscera, 17 were considered major injuries, i.e., 60.7% (0.0024% of the total cases assessed).
Conclusion
The insertion of the Veress needle in the abdominal midline, at the umbilicus, poses serious risk to the life of patients. Therefore, further studies should be conducted to investigate alternative sites for Veress needle insertion.</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Biological and medical sciences</subject><subject>Blood Vessels - injuries</subject><subject>Digestive system. Abdomen</subject><subject>Embolism, Air - etiology</subject><subject>Endoscopy</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Fetal Death - etiology</subject><subject>Gastroenterology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastrointestinal Tract - injuries</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hemorrhage - etiology</subject><subject>Hemorrhage - mortality</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Insufflation - instrumentation</subject><subject>Intraoperative Complications - epidemiology</subject><subject>Intraoperative Complications - etiology</subject><subject>Intraoperative Complications - surgery</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopy</subject><subject>Laparotomy</subject><subject>Literature reviews</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Needles - adverse effects</subject><subject>Other diseases. Semiology</subject><subject>Peritonitis - etiology</subject><subject>Pneumoperitoneum, Artificial - instrumentation</subject><subject>Pregnancy</subject><subject>Prevalence</subject><subject>Proctology</subject><subject>Punctures - adverse effects</subject><subject>Review</subject><subject>Surgery</subject><subject>Urinary Bladder - injuries</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp10U2LFDEQBuAgiju7-gO8SBD01pqv7iTeZNF1YcGLeg2ZdEUydidjqluZf2_GGVwQPCUhTyVFvYQ84-w1Z0y_QcbUoDrGbMekkZ19QDZcSdEJwc1DsmFWsk5oqy7IJeKONW55_5hccCsGyYXakO-3ebfWBEiDXxFGuj3Qr1ABkWaAcQKaMkJdUsk0lkpDBf_nUCLdZ1jnsoealnLcvqWe4gEXmBsJdEoLVL-sFWiFnwl-PSGPop8Qnp7XK_Llw_vP1x-7u083t9fv7rogrV06O3CjwMaR99JrzmQc1WBAcW_HoLfgrTJaQJDbONgIyoY4-D4OcpTCMvDyirw6vbuv5ccKuLg5YYBp8hnKim7QUps2pwZf_AN3Za259eYEt6rX1uiG-AmFWhArRLevafb14DhzxxjcKQbXYnDHGJxtNc_PD6_bGcb7ivPcG3h5Bh6Dn2L1OST86wTXwrDeNCdODttV_gb1vsP___4bLFGhVA</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Azevedo, João Luiz Moreira Coutinho</creator><creator>Azevedo, Otavio Cansanção</creator><creator>Miyahira, Susana Abe</creator><creator>Miguel, Gustavo Peixoto Soares</creator><creator>Becker, Otávio Monteiro</creator><creator>Hypólito, Octávio Henrique Mendes</creator><creator>Machado, Afonso Cesar Cabral Guedes</creator><creator>Cardia, Wellington</creator><creator>Yamaguchi, Gilmara Aguiar</creator><creator>Godinho, Lola</creator><creator>Freire, Dalmer</creator><creator>Almeida, Carlos Eduardo Saldanha</creator><creator>Moreira, Camila Hobi</creator><creator>Freire, Dalmer Faria</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20090701</creationdate><title>Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review</title><author>Azevedo, João Luiz Moreira Coutinho ; Azevedo, Otavio Cansanção ; Miyahira, Susana Abe ; Miguel, Gustavo Peixoto Soares ; Becker, Otávio Monteiro ; Hypólito, Octávio Henrique Mendes ; Machado, Afonso Cesar Cabral Guedes ; Cardia, Wellington ; Yamaguchi, Gilmara Aguiar ; Godinho, Lola ; Freire, Dalmer ; Almeida, Carlos Eduardo Saldanha ; Moreira, Camila Hobi ; Freire, Dalmer Faria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-96184e9fd153a7103fd468e41a9dc7bea94872ec3bf69fe49cf6a5f63d3290ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Biological and medical sciences</topic><topic>Blood Vessels - injuries</topic><topic>Digestive system. Abdomen</topic><topic>Embolism, Air - etiology</topic><topic>Endoscopy</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Fetal Death - etiology</topic><topic>Gastroenterology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastrointestinal Tract - injuries</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hemorrhage - etiology</topic><topic>Hemorrhage - mortality</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Insufflation - instrumentation</topic><topic>Intraoperative Complications - epidemiology</topic><topic>Intraoperative Complications - etiology</topic><topic>Intraoperative Complications - surgery</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopy</topic><topic>Laparotomy</topic><topic>Literature reviews</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Needles - adverse effects</topic><topic>Other diseases. Semiology</topic><topic>Peritonitis - etiology</topic><topic>Pneumoperitoneum, Artificial - instrumentation</topic><topic>Pregnancy</topic><topic>Prevalence</topic><topic>Proctology</topic><topic>Punctures - adverse effects</topic><topic>Review</topic><topic>Surgery</topic><topic>Urinary Bladder - injuries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Azevedo, João Luiz Moreira Coutinho</creatorcontrib><creatorcontrib>Azevedo, Otavio Cansanção</creatorcontrib><creatorcontrib>Miyahira, Susana Abe</creatorcontrib><creatorcontrib>Miguel, Gustavo Peixoto Soares</creatorcontrib><creatorcontrib>Becker, Otávio Monteiro</creatorcontrib><creatorcontrib>Hypólito, Octávio Henrique Mendes</creatorcontrib><creatorcontrib>Machado, Afonso Cesar Cabral Guedes</creatorcontrib><creatorcontrib>Cardia, Wellington</creatorcontrib><creatorcontrib>Yamaguchi, Gilmara Aguiar</creatorcontrib><creatorcontrib>Godinho, Lola</creatorcontrib><creatorcontrib>Freire, Dalmer</creatorcontrib><creatorcontrib>Almeida, Carlos Eduardo Saldanha</creatorcontrib><creatorcontrib>Moreira, Camila Hobi</creatorcontrib><creatorcontrib>Freire, Dalmer Faria</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Azevedo, João Luiz Moreira Coutinho</au><au>Azevedo, Otavio Cansanção</au><au>Miyahira, Susana Abe</au><au>Miguel, Gustavo Peixoto Soares</au><au>Becker, Otávio Monteiro</au><au>Hypólito, Octávio Henrique Mendes</au><au>Machado, Afonso Cesar Cabral Guedes</au><au>Cardia, Wellington</au><au>Yamaguchi, Gilmara Aguiar</au><au>Godinho, Lola</au><au>Freire, Dalmer</au><au>Almeida, Carlos Eduardo Saldanha</au><au>Moreira, Camila Hobi</au><au>Freire, Dalmer Faria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2009-07-01</date><risdate>2009</risdate><volume>23</volume><issue>7</issue><spage>1428</spage><epage>1432</epage><pages>1428-1432</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
The aim of this study was to assess the prevalence, risks, and outcomes of injuries caused by the Veress needle described in the literature.
Methods
Iatrogenic injuries caused by Veress needle insertion during diagnostic or therapeutic laparoscopies in humans were researched, with no language restriction, in the Medline, Lilacs, Embase, Scielo, and Cochrane Library databases. The following words were combined: “Veress” or “insufflation needle” or “pneumoperitoneum needle,” and “complications” or “injuries” or “lesions.” The bibliographic references of the selected articles were also analyzed. We considered the following: (1) number of injuries described in the literature, (2) relationship between number of injuries and number of patients who underwent Veress needle insertion in the studies that reported Veress needle injury, (3) organs and structures injured (retroperitoneal vessels, digestive tract, and self-limited, minor injuries), and (4) outcome (death, conversion to laparotomy, laparoscopic repair, spontaneous resolution).
Results
Thirty-eight selected articles included 696,502 laparoscopies, with 1,575 injuries (0.23%), 126 (8%) of which involved blood vessels or hollow viscera (0.018% of all laparoscopies). Of the 98 vascular injuries, 8 (8.1%) were injuries to major retroperitoneal vessels. There were 34 other reported retroperitoneal injuries, but the authors were not specific as to which vessel was injured. Of the 28 injuries to hollow viscera, 17 were considered major injuries, i.e., 60.7% (0.0024% of the total cases assessed).
Conclusion
The insertion of the Veress needle in the abdominal midline, at the umbilicus, poses serious risk to the life of patients. Therefore, further studies should be conducted to investigate alternative sites for Veress needle insertion.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>19263124</pmid><doi>10.1007/s00464-009-0383-9</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Surgical endoscopy, 2009-07, Vol.23 (7), p.1428-1432 |
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| subjects | Abdomen Abdominal Surgery Biological and medical sciences Blood Vessels - injuries Digestive system. Abdomen Embolism, Air - etiology Endoscopy Equipment Design Female Fetal Death - etiology Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen Gastrointestinal Tract - injuries General aspects Gynecology Hemorrhage - etiology Hemorrhage - mortality Hepatology Humans Insufflation - instrumentation Intraoperative Complications - epidemiology Intraoperative Complications - etiology Intraoperative Complications - surgery Investigative techniques, diagnostic techniques (general aspects) Laparoscopy Laparotomy Literature reviews Medical sciences Medicine Medicine & Public Health Needles - adverse effects Other diseases. Semiology Peritonitis - etiology Pneumoperitoneum, Artificial - instrumentation Pregnancy Prevalence Proctology Punctures - adverse effects Review Surgery Urinary Bladder - injuries |
| title | Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review |
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