Trocars and Verres Needles - Forum


Trocars and Verres Needles - Ärzteforum

Post#1 »

Over the years our gynecologists have given me several perforated or should I say punctured viscera with their trocar insertion technique, that is blind no insufflation. Fortunately, no major vessels although these have occurred elsewhere. When we first started doing lap choles we used the verres needle technique but very quickly changed to a modified Hasson technique after inserting the needle into the stomach on one occasion, no big deal but a great eye opener. Since then we make the same small incision, incise the fascia and open the peritoneum under direct vision and put in our regular ports. After one or two times this method is not only faster and easier but definitely safer and you close the fascia with sutures anyways. I was never very comfortable blindly sticking either a needle or a trocar into the abdomen with or without insufflation, sooner or later no matter how careful you are you are going to strike gold or should I say red or brown. Anyways this works for us.

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Re: Trocars and Verres Needles - Ärzteforum

Post#2 »

I can only echo your experience. What is the obsession with speed? Into the belly 20 seconds earlier? Into the aorta 20 seconds earlier?


Re: Trocars and Verres Needles - Ärzteforum

Post#3 »

About 3 years ago a surgeon, trained by a gynecologist, in laparoscopic "technique" inserted a 10 mm trocar blindly into an uninsufflated abdomen, spearing the iliac artery and vein, resulting in a hemorrhagic fiasco that left a young mother vegetative. With our malpractise program in Canada, all of the general surgeons of the country are paying of a million+ settlement. Mark has told us that this technique is fast and easy. My parents, and my old chief of surgery told me to stay away from things that are fast and easy, whether it be surgical techniques, or women.

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A Doctor

Re: Trocars and Verres Needles - Ärzteforum

Post#4 »

It often scares me to watch other surgeons insert trocars. You can tell from 10 feet away when the trocar "pops" into the peritoneal cavity. When I put one in, I'm the only one who can tell, because I can control the movement of the trocar. So many surgeons hold the trocar with their fingers wrapped around the base, rather than with the index finger extending along the trocar tube itself. If you can't control the instrument, you are going to get into trouble, regardless of whether or not there are a few liters of gas in the belly.

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