Is it necessary to lift the abdominal wall when preparing a pneumoperitoneum? A randomized study

Background: In order to create a pneumoperitoneum with the Veress needle, i t is generally advocated that the abdominal wall should be lifted. Lifting is aimed at increasing the distance between the abdominal wall and the intr aabdominal structures. This study was conducted to compare lifting (L) and nonlifting (NL) of the abdominal wall. Methods: All patients scheduled for laparoscopic surgery without previous a bdominal surgery or morbid obesity were included in the study group. The nu mber of attempts needed for proper positioning of the needle was assessed. Results: A total of 150 patients were randomized. There were no complicatio ns. The number of attempts needed for correct positioning of the Veress nee dle was significantly higher in the L group than in the NL group (31 of 75 vs nine of 75, p < 0.001). The body mass index (BMI) of patients in whom pe ritoneal entry needed more than one puncture was significantly higher than the BMI of patients with immediate proper placement (28.3 vs 24.7 kg/m(2), p < 0.05). Conclusion: Abdominal wall lifting is not necessary.