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Category: Volume 07 Issue 03 March 2019
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Title: Veress Needle Technique –A Gold Standard Method for Attaining Pneumoperitoneum in Laparoscopic Appendicectomy- A Comparison with Open Technique

Authors: Manjunath H R, Reny Jayaprakas

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.141

Abstract

Aim:  To compare outcome and complications in open technique and closed veress needle technique in laparoscopic appendicectomy.

Methods: A randomized study conducted in 90 patients undergoing laparoscopic appendicectomy in Al Azhar Medical College and Hospital from February 2018 to February 2019.Patients fulfilling the Inclusion-Exclusion criteria were included in the study. Group A constituted 45 patients who underwent Open (Hasson) technique while Group B also contains same number of patients who were taken up for Closed (Veress) technique. Open technique was performed through stab incision and then dissecting the fascia for gaining acess to the abdomen by inserting the trochar, while the closed technique involves the direct insertion of veress needle into the abdominal cavity for pneuoperitoneum creation and then trocar placement. The parameters used for comparison were access time, gas leak, visceral injury, vascular injury, need for conversion, port site haematoma /infection/hernia. Cases were assesed on 1st postoperative day, then followed up at 1 week,2 months,6months.

Results: Out of 90 patients, 60 males and 30 females in the age group of 20 to 50 years were included in the study. Mean acess time for pneumoperitoneum was 4+/-1 minute in open technique versus 3+/-1 in open technique. Gas leak was observed in 10 patients in group A and 2 patients in Group B. Pneumoperitoneum was attained in all cases. There was no case of visceral/vascular injury or conversion to open technique.3 patients had postoperative haematoma in Group A.5 patients had port site infections in Group A. Post operative hernia was not detected in 6 months postoperative follow up period.

Conclusion: Both open and closed method to gain acess into peritoneal cavity are safe but Veress needle method has the advantage of quicker access time, fewer complications in comparison to open technique.

Keywords: Pneumoperitoneum, Open Technique, Closed Veress needle Technique, Laparoscopic Appendicectomy.

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Corresponding Author

Reny Jayaprakas

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