Application de l'aiguille de Veress dans l'excision laparoscopique d'un kyste ovarien géant sans pneumopéritoine

A veress needle is a special paracentesis needle with a safety device. It consists of two parts, a needle core and a cannula sheath, and is mainly used for the establishment of pneumoperitoneum in laparoscopy and other low-invasive abdominal operations. The veress needle is used skillfully to absorb the cystic fluid during laparoscopic excision of huge ovarian cysts without pneumoperitoneum.

1. Operation methods of veress needle

After successful epidural anesthesia, the bladder lithotomy position was taken, routine disinfection and towel covering were performed, and a suspension device was placed horizontally on the four fingers below the umbilicus. A longitudinal incision was made on the upper edge of the umbilicus, and a microscope was placed for observation; a 2cm longitudinal incision was made in the middle of the lower abdomen, the upper incision was protected, and 3-0 absorbable suture was used to suture the anterior wall of the cyst to pull the cyst; the veress needle was tightly connected with a 20ml syringe, and the The lower abdominal incision is made into the abdominal cavity to puncture the cyst wall, probe into the cyst cavity, and aspirate the cyst fluid; turn off the switch of the veress needle after pumping 20 ml, remove the syringe, and continue to connect and repeat the suction after emptying. Two 20ml syringes can be prepared on the table for alternate use. The aspirated cystic fluid can be collected in a container or injected directly into an aspirator tube and discarded. After the cystic fluid was fully sucked out, the cystic cavity was sutured to close the cystic cavity, and the bleeding was fully stopped. After the gauze and instruments were counted correctly, the abdominal cavity was closed layer by layer, and the skin was sutured without removing sutures.

2. The advantages of veress needle

Good safety: The veress needle is made according to the design principle. The front end of the needle core is blunt and round, and there are side holes, which can be injected with water, gas and suction; the tail is equipped with a spring. In the sharp needle cover; once it enters the capsule, the resistance disappears, and the needle core pops up automatically by the force of the spring, which can prevent the needle cover from accidentally injuring normal tissues.

Sterile and tumor-free: The unique switch control design of the veress needle can effectively control the outflow of cyst fluid, fully ensure the sterility of the surgical field, avoid cyst fluid contamination of surrounding tissues and tumor cell planting, and fully ensure aseptic operation technology and tumor-free technology.

Reasonable design: The side hole design of the veress needle is convenient for multi-directional suction of cyst fluid, and the suction can be more sufficient and thorough by rotating the veress needle. Compared with the single-sided needle bevel of the abdominal puncture needle, there is no need to adjust the needle angle at a large angle, and the operation is more flexible.

Appropriate specifications: veress needles are available in two lengths, 120 mm and 150 mm; the abdominal puncture needle is 12 gauge, with a total length of 35 cm and an outer diameter of the needle tube of 12 mm. It is not difficult to see from the comparison of the specifications that the length of the veress needle is more suitable for patients with various cyst sizes and various postures; and the inner and outer diameter of the needle tube is thicker than that of the abdominal puncture needle. If the cystic fluid is thick, it is not easy to block the tube and affect suction. . On the other hand, the peritoneal puncture needle is slender and difficult to fix, and the long and sharp puncture needle at the front end has no protective device, which is likely to cause puncture to the surrounding tissue; while the veress needle technique not only has a needle sheath protective device, but also the handle part at the tail end. The anti-slip design is convenient for the operator to operate by hand, increasing stability and safety.

The veress needle is used as a puncture needle for abdominal cysts, especially for cyst fluid aspiration in laparoscopic surgery without pneumoperitoneum. It has the advantages of safer and more convenient operation, reliable suction effect, and fully in line with aseptic and tumor-free techniques. Clinical application. It should be noted that the suctioned cyst fluid will adhere to the inner wall of the veress needle. Therefore, it must be strictly cleaned according to standard procedures after surgery. To achieve no dead ends, no residue.