A RANDOMIZED COMPARISON OF VERRES NEEDLE AND DIRECT TROCAR INSERTION FOR LAPAROSCOPY

Two hundred and fifty-two women scheduled to undergo laparoscopy were randomly assigned to a Verres needle or direct insertion group. The gr oups were similar with respect to incidence of obesity, prior surgical treatment, indication for operation and level of training of the surg eon performing the procedure. There were no major complications associ ated with either technique. Minor complications (preperitoneal insuffl ation, failed entry or more than three attempts necessary to enter the peritoneal cavity with the trocar) were significantly more frequent ( p<0.05) in the Verres needle technique group. One hundred and thirteen of these patients underwent sterilization procedures. The mean times for performance of the laparoscopic procedure using die direct inserti on and Verres needle techniques were 15.3 and 19.6 minutes, respective ly. The time saved using die direct insertion technique is explained b y a significant (p<0.01) reduction in die mean laparoscope insertion t ime, which was 2.2 minutes and 5.9 minutes for the direct insertion an d Verres needle techniques, respectively. We prefer die direct inserti on technique for trocar placement because it has fewer minor complicat ions and requires less operating time.