About the Things Concerning Laparoscopic Veress Needle Puncture.

The name of the veress needle itself is used to form a pneumoperitoneum. Because at the beginning, the abdominal cavity does not have gas, when the first veress needle is used, the abdominal cavity needs to be inflated with carbon dioxide gas. However, the veress needle is relatively thick, and the tip of the veress needle is very sharp, which can cause great damage to the patient. Therefore, a veress needle should be used when forming the pneumoperitoneum in the first step.

The veress needle is a needle-shaped structure 

 With a valve at the back end, when performing a pneumoperitoneum operation, the carbon dioxide gas pipe of the gas cylinder is connected here. The tip of the veress needle is not very sharp but is blunt. This is a very excellent design that can protect the operator or the nurse who needs to perform the operation.

Although the veress needle is blunt, when it comes into contact with the skin and is forced to go downwards, the needle will bounce out and form a puncture needle. In this way, as long as it comes into contact with the skin and is forced, the needle will pop out and slowly penetrate the skin, muscle layer, and serous layer, and then reach the abdominal cavity. If you have experience, you can judge whether you have reached the abdominal cavity by feel.

After reaching the abdominal cavity, you should immediately stop inserting it, because the space and gap of the abdominal cavity are relatively small, and continuing to insert it will damage the internal organs. After entering the abdominal cavity, connect the pneumoperitoneum tube for ventilation. The operator or nurse can gently tap the patient's abdomen and see obvious distension of the abdomen. When the distension reaches a certain level, the first veress needle can be inserted. This is the function of the veress needle.

The first thing to pay attention to when piercing with a veress needle is the choice of the puncture hole.

The choice of the puncture hole depends on many factors, such as the size of the uterus, the scope of the surgery, the thickness of the abdominal wall, and surgical scars, and so on.

• If it is tubal ovarian surgery, you can choose to puncture at the umbilical point.

• When removing a larger uterus, a large ovarian cyst or performing lymph node clearance, the puncture hole and the lens veress needle can be placed 4-6cm at the umbilicus.

• If the patient is not tall and has a short distance between the umbilicus and pubic symphysis, a cut on the umbilicus is also required.

• Puncture should avoid surgical scars as much as possible to prevent damage to intestinal adhesions.

The puncture site of the veress needle is often the site where the first veress needle is placed, but this is not absolute. If the patient is obese, with loose skin, and a lens veress needle needs to be placed on the umbilicus, it is likely that the veress needle will not be able to reach the abdominal cavity after entering. At this time, in addition to replacing a longer veress needle, another feasible method is to enter the veress needle at the umbilical point. This is the thinnest area in the entire abdomen, with little fatty tissue and easy to enter the abdomen. After the air enters to the set intra-abdominal pressure, the lens veress needle can be placed in the umbilicus position. At this time, due to the raised abdominal pressure, the veress needle is relatively easier to enter.