Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 10 , ISSUE 3 ( July-September, 2018 ) > List of Articles

CASE REPORT

An Extensive Extraperitoneal Insufflation due to Veress Needle Associated Complication

Phornsawan Wasinghon

Keywords : Extraperitoneal insufflation, Gilliam uterine suspension, Laparoscopic complication, Veress needle.

Citation Information : Wasinghon P. An Extensive Extraperitoneal Insufflation due to Veress Needle Associated Complication. J South Asian Feder Obs Gynae 2018; 10 (3):222-224.

DOI: 10.5005/jp-journals-10006-1594

Published Online: 01-08-2015

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Aim: The case report presented of the uncommon extensive extraperitoneal insufflation due to Veress needle (VN) procedure of laparoscopy. Background: The minimally invasive surgery has become the method of choice for the most benign disease. Creation of pneumoperitoneum is the first step of a laparoscopy. The Veress needle is placed blindly into the abdomen. There are major and minor complications of laparoscopy. The purpose of this study was to expose the minor complication outcome of extraperitoneal insufflation with VN access. The complication of this operation occurred during the laparoscopic surgical staging of endometrial cancer. Case description: A 61-year-old woman, para two of vaginal deliveries, had previous laparoscopic Gilliam uterine suspension owing to uterine prolapse. She had menorrhagia for 6 months after her menopausal age of 53 years. The uterine had undergone curettage, and the histopathology displayed endometrial carcinoma. The treatment was laparoscopic surgical staging. While the VN was inserted and CO2 insufflation was taking place with 15 mm Hg, a minor intraoperative complication had occurred. The laparoscopy revealed Gilliam uterine suspension (GUS) where the extraperitoneal emphysema had occurred. The extraperitoneal emphysema was released with a needle gauge No.18 exteriorly during surgery. Conclusion: The extensive extraperitoneal insufflation image shows a minor complication that is very uncommon reviewed and can thus be educational for the endoscopist. Clinical significance: The VN was inserted vertically following the creation of pneumoperitoneum at a pressure of 10 to15 mm Hg, the Veress needle was removed. Then a 10 mm disposable shielded trocar was introduced in the pelvic cavity.


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  1. Azevedo JL, Azevedo OC, Miyahira SA, Miguel GP, Becker OM Jr, Hypólito OH, et al. Injuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review. Surg Endosc 2009;23(7):1428-1432.
  2. Candy JW. Modified Gilliam uterine suspension using laparoscopic visualization. Obstet Gynecol 1976;47(2):242- 243.
  3. Bergstrom J, Aloisi A, Armbruster S, Yen TT, Casarin A, Leitao Jr MM, et al. Minimally invasive hysterectomy surgery rates for endometrial cancer performed at national comprehensive cancer network (NCCN) centers. Gynecol Oncol 2018;148(3):480-484.
  4. Ahmad G, Gent D, Henderson D, O'Flynn H, Phillips K, Watson A. Laparoscopic entry techniques. Cochrane database of systematic reviews 2015; September 1. [Epub ahead of print].
  5. Angioli R, Terranova C, Nardone CDC, et al. A comparison of three different entry techniques in gynecological laparoscopic surgery: a randomized prospective trial. Eur J Obstet Gynecol Reprod Biol 2013;17(2):339-342.
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