Comparison of Veress Needle and Direct Trocar Insertion in Establishing Pneumoperitoneum for Laparoscopic Cholecystectomy

Aim: To compare the efficacy and safety of direct trocar insertion and Veress needle to gain access in the abdominal cavity for laparoscopic cholecystectomy Study design: Randomized control study Place and duration of study: Surgical unit II, Akhtar Saeed Trust Teaching Hospital/ Farooq Hospital West Wood , Lahore, from August, 2012 to July, 2014. Methodology: All patients undergoing laparoscopic cholecystectomy during the study period were enrolled. All patients younger (<20years) and older patients (>65years) and those with co morbid conditions were excluded. The remaining was randomized into two groups. In one group, Veress needle was used, while in other group, the trocar was inserted directly to establish pneumoperitoneum. Surgeries were performed by the experienced surgeons of the unit. Results: There were total of 30 patients in each group. The time to establish pneumoperitonium was much less in the direct trocars technique. . In the direct trocars group, gas leak occurred in 5 patients while there were 4 patients in Veress needle group. Conclusion: Our results suggest that with a lower complication rate, direct insertion of the disposable trocar is a safe alternative to Veress needle insertion technique for the creation of pneumoperitoneum. Such an approach has further advantages such as less instrumentation / cost and rapid creation of pneumoperitoneum.