The relevance of Veress needle overshooting reduction; A Survey among 365 surgeons

Abstract

Introduction Safe insertion of the Veress needle in laparoscopy relies on the surgeons’ technical skills in order to stop needle insertion just in time to prevent overshoot in the underlying organs. To reduce this risk, a wide variety of veress needle systems were developed with safety mechanisms that limit de insertion speed, insertion depth or decouples the driving force generated by the hand on the needle. The aim of this study is to evaluate current perceptions related to the use of Veress needles and to investigate the relevance of preventing overshooting of Veress needles among EAES members. Methods An online survey was distributed by the European Association of Endoscopic Surgery (EAES) Executive Office to all active members. The survey consisted of demographic data and 14 questions regarding the use of the Veress needle, the conducted training prior to usage, and the need for improvements. Results A total of 365 (10%) members responded coming from 58 different countries. Of the responding surgeons, 36% prefers the open method for patients with normal BMI, and 22% for patients with high BMI. Of the surgeons using Veress needle, 68% indicated that the reduction of overshoot is beneficial in normal BMI patients, whereas 78% indicated that this is beneficial in high BMI patients. On average, the members that uses the Veress needle used it for 1448 (SD 3031) times and felt comfortable on using it after 22,9 (SD 78,9) times. The average years of experience was 17,6 (SD 11,1) and the surgeons think that a maximum overshoot of 9.4 (SD 5.5) mm is acceptable before using the system safely. Conclusion This survey indicates that despite the risks, Veress needles are still being used by the majority of the laparoscopic surgeons who responded. In addition, the surgeons responded that they are interested in using a Veress needle with extra safety mechanism if it limits the risk of overshooting into the underlying structures.