Tags

Type your tag names separated by a space and hit enter

Latif's point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy.
Asian J Endosc Surg. 2018 May; 11(2):133-137.AJ

Abstract

INTRODUCTION

Creating pneumoperitoneum is the most challenging step during laparoscopy. The periumbilical area is the classic site for Veress needle insertion. We adopted a new access point for peritoneal insufflation.

METHODS

We introduced a new point for Veress needle insertion to create pneumoperitoneum during difficult laparoscopic procedures. The needle is placed between the xiphoid process and the right costal margin, and it then proceeds toward the patient's right axilla. We collected data to compare using this new method of peritoneal insufflation with using Palmer's point for pneumoperitoneum.

RESULTS

Since 2013, we have used this new technique in 570 patients (first group) and Palmer's point in 459 patients (second group). Among these patients, 196 patients (20%) had had previous abdominal operations, 98 patients (10%) had irreducible ventral hernia, and 735 patients (70%) were morbidly obese. The two groups were comparable in terms of patient characteristics. The mean time to create pneumoperitoneum in the first group was 0.8 ± 0.002 min compared to 1.08 ± 0.007 min in the second group (P ≤ 0.5). The mean number of punctures was 1.57 ± 1.02 in the first group compared to 2.9 ± 1.5 in the second group (P≤ 0.5); in the first group, 97% were successful on the first attempt entry, whereas this figure was 91% in second group. In the first group, the liver was punctured in 13 patients without any further complications; no other viscera were punctured. In the second group, gastric puncture occurred in 5 cases, transverse colon in 2 cases, and omental injury in 12 cases.

CONCLUSION

This new access point may represent a safe, fast, and easy way to create pneumoperitoneum, as well as a promising alternative to Palmer's point in patients who are not candidates for classic midline entry.

Authors+Show Affiliations

Department of Surgery, Mansoura University Hospital, Mansoura, Egypt. Department of Surgery, Hafr Albatin Central Hospital, Hafr Albatin, Saudi Arabia.Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.Department of Surgery, Mansoura University Hospital, Mansoura, Egypt.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28856845

Citation

Abd Ellatif, Mohamed E., et al. "Latif's Point: a New Point for Veress Needle Insertion for Pneumoperitoneum in Difficult Laparoscopy." Asian Journal of Endoscopic Surgery, vol. 11, no. 2, 2018, pp. 133-137.
Abd Ellatif ME, Ghnnam WM, Abbas A, et al. Latif's point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy. Asian J Endosc Surg. 2018;11(2):133-137.
Abd Ellatif, M. E., Ghnnam, W. M., Abbas, A., Basheer, M., Dawoud, I., & Ellaithy, R. (2018). Latif's point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy. Asian Journal of Endoscopic Surgery, 11(2), 133-137. https://doi.org/10.1111/ases.12418
Abd Ellatif ME, et al. Latif's Point: a New Point for Veress Needle Insertion for Pneumoperitoneum in Difficult Laparoscopy. Asian J Endosc Surg. 2018;11(2):133-137. PubMed PMID: 28856845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Latif's point: A new point for Veress needle insertion for pneumoperitoneum in difficult laparoscopy. AU - Abd Ellatif,Mohamed E, AU - Ghnnam,Wagih M, AU - Abbas,Ashraf, AU - Basheer,Magdy, AU - Dawoud,Ibrahim, AU - Ellaithy,Ramadan, Y1 - 2017/08/30/ PY - 2016/10/27/received PY - 2017/06/26/revised PY - 2017/07/19/accepted PY - 2017/9/1/pubmed PY - 2018/10/13/medline PY - 2017/9/1/entrez KW - Insufflation KW - Palmer’s point KW - pneumoperitoneum SP - 133 EP - 137 JF - Asian journal of endoscopic surgery JO - Asian J Endosc Surg VL - 11 IS - 2 N2 - INTRODUCTION: Creating pneumoperitoneum is the most challenging step during laparoscopy. The periumbilical area is the classic site for Veress needle insertion. We adopted a new access point for peritoneal insufflation. METHODS: We introduced a new point for Veress needle insertion to create pneumoperitoneum during difficult laparoscopic procedures. The needle is placed between the xiphoid process and the right costal margin, and it then proceeds toward the patient's right axilla. We collected data to compare using this new method of peritoneal insufflation with using Palmer's point for pneumoperitoneum. RESULTS: Since 2013, we have used this new technique in 570 patients (first group) and Palmer's point in 459 patients (second group). Among these patients, 196 patients (20%) had had previous abdominal operations, 98 patients (10%) had irreducible ventral hernia, and 735 patients (70%) were morbidly obese. The two groups were comparable in terms of patient characteristics. The mean time to create pneumoperitoneum in the first group was 0.8 ± 0.002 min compared to 1.08 ± 0.007 min in the second group (P ≤ 0.5). The mean number of punctures was 1.57 ± 1.02 in the first group compared to 2.9 ± 1.5 in the second group (P≤ 0.5); in the first group, 97% were successful on the first attempt entry, whereas this figure was 91% in second group. In the first group, the liver was punctured in 13 patients without any further complications; no other viscera were punctured. In the second group, gastric puncture occurred in 5 cases, transverse colon in 2 cases, and omental injury in 12 cases. CONCLUSION: This new access point may represent a safe, fast, and easy way to create pneumoperitoneum, as well as a promising alternative to Palmer's point in patients who are not candidates for classic midline entry. SN - 1758-5910 UR - https://www.unboundmedicine.com/medline/citation/28856845/Latif's_point:_A_new_point_for_Veress_needle_insertion_for_pneumoperitoneum_in_difficult_laparoscopy_ L2 - https://doi.org/10.1111/ases.12418 DB - PRIME DP - Unbound Medicine ER -